Provider Demographics
NPI:1629050174
Name:LYNN, BILLY PAUL (MD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:PAUL
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 SAINT SEBASTIAN WAY STE 1A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2635
Mailing Address - Country:US
Mailing Address - Phone:706-651-8400
Mailing Address - Fax:706-651-8868
Practice Address - Street 1:820 SAINT SEBASTIAN WAY STE 1A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2635
Practice Address - Country:US
Practice Address - Phone:706-651-8400
Practice Address - Fax:706-651-8868
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC135492086S0122X
GA0242902086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC135491Medicaid
GA000445717AMedicaid
24BCBKBMedicare PIN
GA000445717AMedicaid