Vanwagnen, Lynn Clark

Vanwagnen, Lynn Clark is an sole proprietor health care provider with primary practice located at 1310 Greenwood Ave , Jackson MI 49203-3077. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Vanwagnen, Lynn Clark can be contacted via phone (517) 787-1990.

Contact Information

Primary practice address
1310 Greenwood Ave Jackson MI 49203-3077
Phone: (517) 787-1990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301038051 Michigan

Profile Details

NPI number 1609833359
LBN Legal business name Vanwagnen, Lynn Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2006
Last updated Oct 10th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609833359 NPPES
Michigan Other 110241201 RR MEDICARE
Michigan MEDICAID 101587882 RR MEDICARE

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