MEDICARE: DR. SUSIE WARREN LYNN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	16543	AL

General Provider Information

NPI Number	:	1598814402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSIE WARREN LYNN M.D.

Provider Business Mailing Address
First Line	:	6767 OLD MADISON PIKE NW
Second Line	:	BUILDING 4, SUITE 400
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2172
Country	:	US
Telephone Number	:	256-922-6675
Fax Number	:	256-922-6660

Provider Business Practice Location Address
First Line	:	9238 MADISON BLVD
Second Line	:	BUILDING 1, SUITE 200
City	:	MADISON
State	:	AL
Zip	:	35758-9100
Country	:	US
Telephone Number	:	256-774-7300
Fax Number	:	256-774-5300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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