Provider Demographics
NPI:1023086733
Name:ROONEY, LYNN L (MD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:L
Last Name:ROONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-3382
Mailing Address - Fax:
Practice Address - Street 1:1375 E 20TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5423
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:303-861-3668
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09128735Medicaid
CO020251OtherKAISER COMMERCIAL NUMBER
COCO305944Medicare PIN
COH83943Medicare UPIN
CO09128735Medicaid