Provider Demographics
NPI:1437386315
Name:RANSOM, LINDSEY MANGHAM (MD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MANGHAM
Last Name:RANSOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2634
Mailing Address - Country:US
Mailing Address - Phone:770-739-9292
Mailing Address - Fax:
Practice Address - Street 1:915 THORNTON RD
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2634
Practice Address - Country:US
Practice Address - Phone:770-739-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67502208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125025AMedicaid
GA003125025BMedicaid