Provider Demographics
NPI:1558365395
Name:FLORKEY, LINDSAY NICCOLE (OD, MS)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:NICCOLE
Last Name:FLORKEY
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2233
Mailing Address - Country:US
Mailing Address - Phone:937-376-4055
Mailing Address - Fax:937-376-3969
Practice Address - Street 1:322 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2233
Practice Address - Country:US
Practice Address - Phone:937-376-4055
Practice Address - Fax:937-376-3969
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5469152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2630531Medicaid
OH2630531Medicaid