Provider Demographics
NPI:1447587423
Name:FIACCO, LINDSEY BOXXE (MD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BOXXE
Last Name:FIACCO
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 1:201 SAGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6510
Mailing Address - Country:US
Mailing Address - Phone:919-385-2030
Mailing Address - Fax:919-385-2094
Practice Address - Street 1:201 SAGE RD STE 300
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6510
Practice Address - Country:US
Practice Address - Phone:919-385-2030
Practice Address - Fax:919-385-2094
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225737208000000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program