Provider Demographics
NPI:1619729241
Name:DAY, LINDSAY WALLACE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:WALLACE
Last Name:DAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 JOHNS RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4703
Mailing Address - Country:US
Mailing Address - Phone:706-831-7864
Mailing Address - Fax:
Practice Address - Street 1:465 N BELAIR RD STE 2B
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3190
Practice Address - Country:US
Practice Address - Phone:706-774-7400
Practice Address - Fax:706-774-7590
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12072363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant