Provider Demographics
NPI:1902943988
Name:BROWN, LYNETTE MARDEL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:MARDEL
Last Name:BROWN
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:5121 S. COTTONWOOD SUITE 307
Mailing Address - Street 2:INTERMOUNTAIN MEDICAL CENTER
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84157
Mailing Address - Country:US
Mailing Address - Phone:801-507-3378
Mailing Address - Fax:801-507-3375
Practice Address - Street 1:5121 S. COTTONWOOD SUITE 307
Practice Address - Street 2:INTERMOUNTAIN MEDICAL CENTER
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84157-7000
Practice Address - Country:US
Practice Address - Phone:801-507-3378
Practice Address - Fax:801-507-3375
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDZ9987207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT36798OtherINTERMOUNTAIN MEDICAL CENTER PHYSICIAN ID CODE
MDZ9987OtherHOPKINS MD ID#