Provider Demographics
NPI:1598814402
Name:LYNN, SUSIE WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSIE
Middle Name:WARREN
Last Name:LYNN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:6767 OLD MADISON PIKE NW
Mailing Address - Street 2:BUILDING 4, SUITE 400
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2172
Mailing Address - Country:US
Mailing Address - Phone:256-922-6675
Mailing Address - Fax:256-922-6660
Practice Address - Street 1:9238 MADISON BLVD
Practice Address - Street 2:BUILDING 1, SUITE 200
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9100
Practice Address - Country:US
Practice Address - Phone:256-774-7300
Practice Address - Fax:256-774-5300
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AL165432083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF40830Medicare UPIN