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Individual

LORI A LYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
48 MEDICAL PARK EAST DR, SUITE 356, BIRMINGHAM, AL 35235
(205) 838-3200
(205) 838-6981
Mailing address
48 MEDICAL PARK EAST DR, SUITE 356, BIRMINGHAM, AL 35235
(205) 838-3200
(205) 838-6981

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO795
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009972355
AL
05
051556109
AL
01
1538173281
GROUP NPI
AL
01
51528670
BCBS
AL
01
CK7413
RR MEDICARE GROUP ID
AL
01
J210
GROUP MEDICARE
AL
01
P00167784
RR MCR
01
P00274219
NEW RR MEDICARE PTAN 5/9/08
AL
Enumeration date
07/28/2006
Last updated
05/09/2008
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