Provider Demographics
NPI:1184864431
Name:RERKO, LINDSAY (DO)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:RERKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALTAIR PKWY STE 3100
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7653
Mailing Address - Country:US
Mailing Address - Phone:614-360-9995
Mailing Address - Fax:614-745-0165
Practice Address - Street 1:400 ALTAIR PKWY STE 3100
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7653
Practice Address - Country:US
Practice Address - Phone:614-360-9995
Practice Address - Fax:614-745-0165
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-009871207Q00000X
PAOS-016056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine