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Individual

DR. LYNN J WALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 231-3114
(573) 231-3721
Mailing address
100 MEDICAL DR, P.O. BOX 311, HANNIBAL, MO 63401-6877
(573) 231-3114
(573) 231-3721

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R9499
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201080702
MO
Enumeration date
01/12/2006
Last updated
01/02/2014
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