Organization
ST LUKES MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J LYNCH M.D. (OWNER)
(970) 223-1199
Entity
Organization
Contact information
Practice address
1101 OAKRIDGE DR, SUITE B, FORT COLLINS, CO 80525-5591
(970) 223-1199
(970) 223-9566
Mailing address
1101 OAKRIDGE DR, SUITE B, FORT COLLINS, CO 80525-5591
(970) 223-1199
(970) 223-9566
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24854
CO
363LF0000X
Family Nurse Practitioner
57743
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07009216
—
CO
Enumeration date
09/20/2006
Last updated
03/24/2008
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