Provider Demographics
NPI:1023017712
Name:LYNCH, ADRIENNE MARIE (PA)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:MARIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7001 HODGSON MEMORIAL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2549
Mailing Address - Country:US
Mailing Address - Phone:912-354-6303
Mailing Address - Fax:912-355-8655
Practice Address - Street 1:7001 HODGSON MEMORIAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2549
Practice Address - Country:US
Practice Address - Phone:912-354-6303
Practice Address - Fax:912-355-8655
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA002417363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0014PAMedicaid
P59210Medicare UPIN
SC0014PAMedicaid