Provider Demographics
NPI:1720246556
Name:LYNN J. KERN, M.D., P.C.
Entity Type:Organization
Organization Name:LYNN J. KERN, M.D., P.C.
Other - Org Name:LYNN J. KERN, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-685-6914
Mailing Address - Street 1:601 JOHN ST STE M-325
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5358
Mailing Address - Country:US
Mailing Address - Phone:269-385-3534
Mailing Address - Fax:
Practice Address - Street 1:601 JOHN ST STE M-325
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5358
Practice Address - Country:US
Practice Address - Phone:269-385-3534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036731207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101705206Medicaid
MI101705206Medicaid
MIAK7135812OtherDEA NUMBER
MI0390530Medicare Oscar/Certification