Individual
DR. LARRY WADE LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01037887
IN
208D00000X
General Practice Physician
01037887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100356530
—
IN
01
—
P01456893
MEDICARE RAILROAD PTAN
IN
Enumeration date
03/15/2007
Last updated
07/06/2023
Update your record
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