Provider Demographics
NPI:1801144126
Name:LYNCH, THOMAS P (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3490 BALLYBRIDGE CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-0920
Mailing Address - Country:US
Mailing Address - Phone:865-567-9877
Mailing Address - Fax:
Practice Address - Street 1:3490 BALLYBRIDGE CIR APT 201
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-0920
Practice Address - Country:US
Practice Address - Phone:865-567-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD71022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology