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Individual

JACOB RYAN LYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-0123
(248) 898-1473
Mailing address
26901 BEAUMONT BLVD # 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1952
(947) 522-0307

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010017
MI
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
PA.200096
LA
363AS0400X
Surgical Physician Assistant
PA60030903
WA
363AS0400X
Surgical Physician Assistant
TPA0012
MS

Other

Enumeration date
01/16/2007
Last updated
10/31/2024
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