Provider Demographics
NPI:1215190343
Name:STUDSTILL, SHERRI LYNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:LYNETTE
Last Name:STUDSTILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 GATEWAY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-5681
Mailing Address - Country:US
Mailing Address - Phone:706-243-0174
Mailing Address - Fax:706-243-0178
Practice Address - Street 1:6509 GATEWAY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-5681
Practice Address - Country:US
Practice Address - Phone:706-243-0174
Practice Address - Fax:706-243-0178
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003130462AMedicaid