Provider Demographics
NPI:1497929376
Name:LYNN, JODA GARVIN (MD)
Entity type:Individual
Prefix:DR
First Name:JODA
Middle Name:GARVIN
Last Name:LYNN
Suffix:
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 1:127 LACOUR LANE
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348
Mailing Address - Country:US
Mailing Address - Phone:850-584-2000
Mailing Address - Fax:850-584-2000
Practice Address - Street 1:135 AVENUE G
Practice Address - Street 2:
Practice Address - City:APALACHICOLA
Practice Address - State:FL
Practice Address - Zip Code:32320
Practice Address - Country:US
Practice Address - Phone:850-653-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine