Provider Demographics
NPI:1164491668
Name:TENHOOR, TERRI LYNN (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:TENHOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:404-294-4018
Mailing Address - Fax:404-294-1359
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 430
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-294-4018
Practice Address - Fax:404-294-1359
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA039684207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00717824EMedicaid
GA1164491668OtherNPI
GA00717824CMedicaid
GAG05411Medicare UPIN
GA00717824EMedicaid