Provider Demographics
NPI:1477284768
Name:LINGG, CAITLIN MARY (OD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARY
Last Name:LINGG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 DORNOCH WAY APT 201
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6845
Mailing Address - Country:US
Mailing Address - Phone:785-656-2469
Mailing Address - Fax:
Practice Address - Street 1:2520 N 14TH AVE
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2315
Practice Address - Country:US
Practice Address - Phone:620-227-3071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-18
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2175152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist