Provider Demographics
NPI:1700818085
Name:LINDSAY, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4953 N HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-1733
Mailing Address - Country:US
Mailing Address - Phone:208-387-6949
Mailing Address - Fax:208-331-7479
Practice Address - Street 1:650 N COLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9117
Practice Address - Country:US
Practice Address - Phone:208-323-1222
Practice Address - Fax:208-323-1825
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM3973208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
000010001035OtherREGENCE BS OF IDAHO
86611OtherBLUE CROSS OF IDAHO
000010001035OtherREGENCE BS OF IDAHO