Provider Demographics
NPI:1275210312
Name:LINDSEY, EDWARD EARL JR
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:EARL
Last Name:LINDSEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32129 E 721 RD
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-7390
Mailing Address - Country:US
Mailing Address - Phone:501-467-4758
Mailing Address - Fax:
Practice Address - Street 1:215 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-4439
Practice Address - Country:US
Practice Address - Phone:918-201-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist