Provider Demographics
NPI:1952358541
Name:TUGGLE, LYNN KENNETH JR (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:KENNETH
Last Name:TUGGLE
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:ONE VANTAGE WAY
Mailing Address - Street 2:SUITE B240, MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1562
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 N. HIGHLAND AVE.
Practice Address - Street 2:MIDDLE TENNESSEE MEDICAL CENTER
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:615-284-8484
Practice Address - Fax:615-284-3854
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39801207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3332652Medicaid
TN4108240OtherBCBS
TNP00234826OtherRAILROAD MEDICARE
TNP00234826OtherRAILROAD MEDICARE
TN4108240OtherBCBS