Provider Demographics
NPI:1295964724
Name:FLYNN, WILLIAM J (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:FLYNN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:3252 WEST LAKE STREET #A
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5374
Mailing Address - Country:US
Mailing Address - Phone:912-926-2878
Mailing Address - Fax:612-920-4303
Practice Address - Street 1:3252 WEST LAKE STREET #A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-5374
Practice Address - Country:US
Practice Address - Phone:912-926-2878
Practice Address - Fax:612-920-4303
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010262152W00000X
MN3277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist