Provider Demographics
NPI:1922144278
Name:DR. LAWRENCE LYNCH
Entity Type:Organization
Organization Name:DR. LAWRENCE LYNCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTAILING
Authorized Official - Prefix:
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-355-0433
Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-355-0433
Mailing Address - Fax:912-355-4238
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-355-0433
Practice Address - Fax:912-355-4238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA022224OtherBCBS
GAD30107Medicare UPIN
GAGRP1974Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER