Provider Demographics
NPI:1649240169
Name:DOLSON, A. LYNN H (MD)
Entity Type:Individual
Prefix:DR
First Name:A. LYNN
Middle Name:H
Last Name:DOLSON
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 1:1614 MAHAN CENTER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5474
Mailing Address - Country:US
Mailing Address - Phone:850-591-9703
Mailing Address - Fax:
Practice Address - Street 1:3726 BOBBIN BRK E
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-1240
Practice Address - Country:US
Practice Address - Phone:850-591-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58576207ZP0102X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26574OtherBCBS INDIVIDUAL PROVIDER
FLME58576OtherFL MEDICAL EXAMINER LICEN