Individual
MR. GARY L LYND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
724 W FRANKLIN ST, JACKSON, MI 49201-2008
(517) 784-3100
Mailing address
724 W FRANKLIN ST, JACKSON, MI 49201-2008
(517) 784-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010466
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120022
PHP
—
01
—
0153825775
BCBS
MI
05
—
4443170
—
MI
Enumeration date
10/13/2005
Last updated
03/18/2021
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