Provider Demographics
NPI:1629273222
Name:LINDSAY, JAMIE N (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:N
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:797 S WABASH ST
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-3332
Mailing Address - Country:US
Mailing Address - Phone:260-563-0700
Mailing Address - Fax:260-274-0134
Practice Address - Street 1:1000 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1070
Practice Address - Country:US
Practice Address - Phone:765-472-5335
Practice Address - Fax:260-479-2921
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003352A207Q00000X
IN02003352B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN941160A5Medicare PIN