| Lynn Van Wagnen Md Pc | |
|
1310 Greenwood Ave Jackson MI 49203-3077 | |
| (517) 787-1990 | |
| (517) 787-9183 |
| Full Name | Lynn Van Wagnen Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1310 Greenwood Ave, Jackson, Michigan |
| Authorized Official Name and Position | Lynn Clark Van Wagnen (PHYSICIAN) |
| Authorized Official Contact | 5177871990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn Van Wagnen Md Pc 1310 Greenwood Ave Jackson MI 49203-3077 Ph: (517) 787-1990 | Lynn Van Wagnen Md Pc 1310 Greenwood Ave Jackson MI 49203-3077 Ph: (517) 787-1990 |
| NPI Number | 1396973129 |
|---|---|
| Provider Enumeration Date | 07/01/2009 |
| Last Update Date | 07/27/2009 |
| Medicare PECOS PAC ID | 1951447549 |
|---|---|
| Medicare Enrollment ID | O20091013000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396973129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 038051 (Michigan) | Primary |
| Provider Name | Lynn C Vanwagnen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609833359 PECOS PAC ID: 0244136075 Enrollment ID: I20091013000163 |
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