Provider Demographics
NPI:1407952559
Name:FOLEY, LYNN M (MD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:M
Last Name:FOLEY
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 1:2195 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3830
Mailing Address - Country:US
Mailing Address - Phone:901-756-8168
Mailing Address - Fax:901-752-3791
Practice Address - Street 1:2195 WEST STREET
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3830
Practice Address - Country:US
Practice Address - Phone:901-756-8168
Practice Address - Fax:901-752-3791
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25984207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN003011068OtherBCBS
TNC15635Medicare UPIN
TN003011068OtherBCBS