Provider Demographics
NPI:1073854469
Name:A LYNN DOLSON, MD, LLC
Entity Type:Organization
Organization Name:A LYNN DOLSON, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-591-9703
Mailing Address - Street 1:1614 MAHAN CENTER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5474
Mailing Address - Country:US
Mailing Address - Phone:850-591-9703
Mailing Address - Fax:
Practice Address - Street 1:1614 MAHAN CENTER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5474
Practice Address - Country:US
Practice Address - Phone:850-591-9703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME585762083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty