Provider Demographics
NPI:1669582151
Name:WILLIAM J. LYNCH, D.O., INC.
Entity type:Organization
Organization Name:WILLIAM J. LYNCH, D.O., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:D.O.
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-849-3023
Mailing Address - Street 1:127 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1121
Mailing Address - Country:US
Mailing Address - Phone:814-849-3023
Mailing Address - Fax:814-849-5048
Practice Address - Street 1:127 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1121
Practice Address - Country:US
Practice Address - Phone:814-849-3023
Practice Address - Fax:814-849-5048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007276930001Medicaid
PA0007276930001Medicaid