Provider Demographics
NPI:1528416708
Name:MARTIN, LINDSAY CHITWOOD (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:CHITWOOD
Last Name:MARTIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:CHITWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1977 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CANON
Mailing Address - State:GA
Mailing Address - Zip Code:30520-1409
Mailing Address - Country:US
Mailing Address - Phone:706-599-5407
Mailing Address - Fax:
Practice Address - Street 1:58 E DOYLE ST
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-3009
Practice Address - Country:US
Practice Address - Phone:706-886-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-29
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist