Healthcare Provider Details

I. General information

NPI: 1740227065
Provider Name (Legal Business Name): SHERWOOD C. LYNN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 N INTERSTATE 35 SUITE 200
AUSTIN TX
78753-5751
US

IV. Provider business mailing address

8401 N INTERSTATE 35 SUITE 200
AUSTIN TX
78753-5751
US

V. Phone/Fax

Practice location:
  • Phone: 512-250-1005
  • Fax: 512-832-6568
Mailing address:
  • Phone: 512-250-1005
  • Fax: 512-832-6568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberE6484
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17601
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: