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Individual

DR. LENNON D WYCHE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5354 REYNOLDS ST, STE 102, SAVANNAH, GA 31405-6007
(912) 355-7554
(912) 355-0988
Mailing address
PO BOX 8006, SAVANNAH, GA 31412-8006
(912) 355-7554
(912) 355-0988

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
031160
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00785012A
GA
05
1784516
LA
01
701582
BLUECROSS BLUESHIELD GA
GA
Enumeration date
01/26/2006
Last updated
07/08/2007
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