Provider Demographics
NPI:1689630378
Name:WORRELL, LINDSAY ANDRE (MB BS FAAP)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ANDRE
Last Name:WORRELL
Suffix:
Gender:M
Credentials:MB BS FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3185 N LESLIE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7211
Mailing Address - Country:US
Mailing Address - Phone:575-534-0400
Mailing Address - Fax:575-534-0600
Practice Address - Street 1:1313 E 32ND ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7251
Practice Address - Country:US
Practice Address - Phone:575-956-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0045208000000X
MS23008208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics