Healthcare Provider Details

I. General information

NPI: 1619045184
Provider Name (Legal Business Name): LYNETTE M ADAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 NORTH MAIN STREET SUITE B
SHELBYVILLE TN
37160-2610
US

IV. Provider business mailing address

1612 NORTH MAIN STREET SUITE B
SHELBYVILLE TN
37160-2610
US

V. Phone/Fax

Practice location:
  • Phone: 931-685-2022
  • Fax: 931-685-4158
Mailing address:
  • Phone: 931-685-2022
  • Fax: 931-685-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD29483
License Number StateTN

VIII. Authorized Official

Name: DR. LYNETTE M ADAMS
Title or Position: DOCTOR
Credential: M.D.
Phone: 931-685-2022