Provider Demographics
NPI:1376930586
Name:LINDSAY, JOHN WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:13 AIRPORT RD # 1012
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-3401
Mailing Address - Country:US
Mailing Address - Phone:203-561-9085
Mailing Address - Fax:
Practice Address - Street 1:85 POHEGANUT DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3252
Practice Address - Country:US
Practice Address - Phone:860-448-6303
Practice Address - Fax:860-448-9678
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00872207R00000X
CT56637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCSP.0066084OtherCT CONTROLLED SUBSTANCE
CT56637OtherCT MEDICAL LICENSE
MA291236OtherMA MEDICAL LICENSE
RIDO00872OtherRI MEDICAL LICENSE
RICDO00872OtherRI CONTROLLED SUBSTANCE
MEDO3524OtherMAINE MEDICAL LICENSE
VA0102208157OtherVIRGINIA MEDICAL LICENSE
MAMCS010606AOtherMA CONTROLLED SUBSTANCE LICENSE