Provider Demographics
NPI:1417709643
Name:LINDSEY, DARRYL ROBERT JR
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:ROBERT
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 1:4669 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4914
Mailing Address - Country:US
Mailing Address - Phone:410-662-8606
Mailing Address - Fax:410-662-8608
Practice Address - Street 1:4669 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4914
Practice Address - Country:US
Practice Address - Phone:410-662-8606
Practice Address - Fax:410-662-8608
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD933155077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist