Provider Demographics
NPI:1013215631
Name:WHEELESS, LINDSEY MICHELE (LINDSEY WHEELESS)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELE
Last Name:WHEELESS
Suffix:
Gender:F
Credentials:LINDSEY WHEELESS
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MICHELE
Other - Last Name:REDMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LINDSEY REDMON
Mailing Address - Street 1:4030 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-6389
Mailing Address - Country:US
Mailing Address - Phone:334-792-2261
Mailing Address - Fax:334-673-0492
Practice Address - Street 1:4030 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-6389
Practice Address - Country:US
Practice Address - Phone:334-792-2261
Practice Address - Fax:334-673-0492
Is Sole Proprietor?:No
Enumeration Date:2011-03-06
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16080183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist