Provider Demographics
NPI:1780616938
Name:LYMAN, JENNIFER MCCOY (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MCCOY
Last Name:LYMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:960 JOHNSON FY RD NE
Mailing Address - Street 2:STE 400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1631
Mailing Address - Country:US
Mailing Address - Phone:404-257-0170
Mailing Address - Fax:404-591-3146
Practice Address - Street 1:960 JOHNSON FY RD NE
Practice Address - Street 2:STE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1631
Practice Address - Country:US
Practice Address - Phone:404-257-0170
Practice Address - Fax:404-591-3146
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA050039207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000916242FMedicaid
GA000916242FMedicaid
GA000916242DMedicaid
GA8892449OtherCIGNA
GA7571346OtherAETNA/USHC
GA00916242AMedicaid
H43344Medicare UPIN
GA160055848OtherRAILROAD MEDICARE
GA2825931OtherAETNA/USHC
GA000916242EMedicaid
GA0701147OtherUNITED HEALTHCARE