Organization Name: | A LYNN LUTHER MDPC |
NPI Number: | 1073841037 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ABNER LYNN LUTHER (PRESIDENT) |
Mailing Address: | 201 N Main St Suite C Boaz |
State: | AL US |
Postal Code: | 359571601 |
Phone Number: | 2565932840 |
Fax Number: | |
NPI Enumeration Date: | 12/02/2009 |
NPI Last Update Date: | 06/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |