Provider Demographics
NPI:1992909931
Name:VARNER, AMY LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:VARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1699
Mailing Address - Country:US
Mailing Address - Phone:404-255-9100
Mailing Address - Fax:404-257-7171
Practice Address - Street 1:3525 BUSBEE DR NW STE 100
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5677
Practice Address - Country:US
Practice Address - Phone:770-422-0064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202907812DMedicaid
GA202907812EMedicaid
GA202I088688Medicare PIN
GAOTH000Medicare UPIN
GA202907812DMedicaid