Provider Demographics
NPI:1588647309
Name:LINDSEY, BRAD STEPHEN (OD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:STEPHEN
Last Name:LINDSEY
Suffix:
Gender:M
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:PO BOX 688
Mailing Address - Street 2:1550 EAST MORRIS BLVD
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37815-0688
Mailing Address - Country:US
Mailing Address - Phone:423-585-5857
Mailing Address - Fax:423-585-5904
Practice Address - Street 1:1550 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2153
Practice Address - Country:US
Practice Address - Phone:423-585-5857
Practice Address - Fax:423-585-5904
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1422152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3598540Medicaid
TN3598540Medicare ID - Type Unspecified
TN3598540Medicaid