Provider Demographics
NPI:1720611320
Name:SHERRY LYNN C WOLF MD PA
Entity type:Organization
Organization Name:SHERRY LYNN C WOLF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN C
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-552-9991
Mailing Address - Street 1:1000 GARLAND JOHNSTON DR
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-4097
Mailing Address - Country:US
Mailing Address - Phone:940-552-9991
Mailing Address - Fax:940-553-1358
Practice Address - Street 1:1000 GARLAND JOHNSTON DR
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-4097
Practice Address - Country:US
Practice Address - Phone:940-552-9991
Practice Address - Fax:940-553-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty