Provider Demographics
NPI:1770562266
Name:STRUTHERS, LYNN M (MD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:M
Last Name:STRUTHERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 N. FORBES BLVD.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745
Mailing Address - Country:US
Mailing Address - Phone:520-760-8972
Mailing Address - Fax:520-760-3417
Practice Address - Street 1:8826 E TANQUE VERDE RD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749
Practice Address - Country:US
Practice Address - Phone:520-760-8972
Practice Address - Fax:520-760-3417
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ290768Medicaid
AZ290768Medicaid
D37719Medicare UPIN