Provider Demographics
NPI:1740227065
Name:LYNN, SHERWOOD C JR (MD)
Entity Type:Individual
Prefix:
First Name:SHERWOOD
Middle Name:C
Last Name:LYNN
Suffix:JR
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 1:8401 N INTERSTATE 35
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5751
Mailing Address - Country:US
Mailing Address - Phone:512-250-1005
Mailing Address - Fax:512-832-6568
Practice Address - Street 1:8401 N INTERSTATE 35
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-5751
Practice Address - Country:US
Practice Address - Phone:512-250-1005
Practice Address - Fax:512-832-6568
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6484207VG0400X
AL17601207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532621OtherBLUE CROSS
FL255985400Medicaid
AL51086154OtherBLUE CROSS
AL000086154Medicaid
MS00112402Medicaid
AL74-10462OtherUNITED HEALTH CARE
AL51086154Medicare ID - Type Unspecified
AL000086154Medicaid