Provider Demographics
NPI:1730287012
Name:ZAHNER, LYNN ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ELLEN
Last Name:ZAHNER
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 1:337 W PIKE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4843
Mailing Address - Country:US
Mailing Address - Phone:770-339-0332
Mailing Address - Fax:770-339-1677
Practice Address - Street 1:337 W PIKE ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4843
Practice Address - Country:US
Practice Address - Phone:770-339-0332
Practice Address - Fax:770-339-1677
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAP30933207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000419691BMedicaid
GA000419691BMedicaid
16BDCTZMedicare ID - Type Unspecified