Basic Information
| Provider Information | |||||||||
| NPI: | 1952358541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUGGLE | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | KENNETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE VANTAGE WAY | ||||||||
| Address2: | SUITE B240, MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372281562 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 N. HIGHLAND AVE. | ||||||||
| Address2: | MIDDLE TENNESSEE MEDICAL CENTER | ||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152848484 | ||||||||
| FaxNumber: | 6152843854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2006 | ||||||||
| LastUpdateDate: | 07/16/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 39801 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3332652 | 05 | TN | MEDICAID | 4108240 | 01 | TN | BCBS | OTHER | P00234826 | 01 | TN | RAILROAD MEDICARE | OTHER |