Provider Demographics
NPI:1184604019
Name:LYNK, RODNEY H (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:H
Last Name:LYNK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5529 ROSECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1819
Mailing Address - Country:US
Mailing Address - Phone:440-960-2154
Mailing Address - Fax:440-365-0117
Practice Address - Street 1:1180 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6306
Practice Address - Country:US
Practice Address - Phone:440-365-5965
Practice Address - Fax:440-365-0117
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH45156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0431661Medicaid
OH0892822Medicare PIN
OHC01871Medicare UPIN