Provider Demographics
NPI:1053500231
Name:CAROL I. LYNN, MD GYNECOLOGY, PLLC
Entity type:Organization
Organization Name:CAROL I. LYNN, MD GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:I
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-755-2900
Mailing Address - Street 1:2136 EXETER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3953
Mailing Address - Country:US
Mailing Address - Phone:901-755-2900
Mailing Address - Fax:901-755-2975
Practice Address - Street 1:2136 EXETER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3953
Practice Address - Country:US
Practice Address - Phone:901-755-2900
Practice Address - Fax:901-755-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25604207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty