Individual
DR. LYNN BRYCE MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 264-3937
(601) 264-5930
Mailing address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 264-3937
(601) 264-5930
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
06437
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115828
—
MS
01
—
512I180020
MEDICARE PTAN FOR SOUTHERN EYE PHYSICIAN'S CENTER LLC
MS
01
—
512I180021
MEDICARE PTAN FOR SOUTHERN EYE SURGERY CENTER LLC
MS
Enumeration date
05/23/2005
Last updated
01/15/2009
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