Provider Demographics
NPI:1174191720
Name:GEORGE, LINDSEY (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 COTTON CT
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:AL
Mailing Address - Zip Code:36856-5415
Mailing Address - Country:US
Mailing Address - Phone:870-291-2663
Mailing Address - Fax:
Practice Address - Street 1:2111 TIGER TOWN PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5487
Practice Address - Country:US
Practice Address - Phone:334-528-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003335152W00000X
AR2823152W00000X
ALS-E82152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist