Provider Demographics
NPI:1619187184
Name:BUSWELL-CLEARY, LINDSEY ANN (DO)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:BUSWELL-CLEARY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:BUSWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:420 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-1165
Mailing Address - Country:US
Mailing Address - Phone:920-386-8101
Mailing Address - Fax:920-386-8109
Practice Address - Street 1:420 W NORTH ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-1165
Practice Address - Country:US
Practice Address - Phone:920-386-8101
Practice Address - Fax:920-386-8109
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.117396207Q00000X
WI53878-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine