Provider Demographics
NPI:1114182458
Name:LYNN, THADDEUS KEDRON (MD)
Entity Type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:KEDRON
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8495 DUNWOODY PL
Mailing Address - Street 2:BUILDING 9, SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3321
Mailing Address - Country:US
Mailing Address - Phone:770-817-8423
Mailing Address - Fax:770-817-8424
Practice Address - Street 1:8495 DUNWOODY PL
Practice Address - Street 2:BUILDING 9, SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-3321
Practice Address - Country:US
Practice Address - Phone:770-817-8423
Practice Address - Fax:770-817-8424
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2015-04-29
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Provider Licenses
StateLicense IDTaxonomies
NY048207Q00000X
GA059670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine