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Organization

LINDY WYATT MD LLC

Active
Other names
Pain Management of the Ohio Valley
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LINDY WYATT MD/PHD (OWNER)
(937) 672-4730
Entity
Organization

Contact information

Practice address
6406 THORNBERRY CT, SUITE 220B, MASON, OH 45040-7880
(937) 672-4730
(513) 433-5475
Mailing address
PO BOX 42370, CINCINNATI, OH 45242-0370
(937) 672-4730
(513) 433-5475

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10831537
CAQH
05
2018579
OH
01
35-072489
OH LICENSE
OH
01
439-96-3405-00
BWC
OH
01
G58818
UPIN
Enumeration date
02/04/2009
Last updated
03/11/2010
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