Provider Demographics
NPI:1760158257
Name:MCCALLON, LINDSEY BROOKE (OD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BROOKE
Last Name:MCCALLON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 E UNIVERSITY DR STE 110
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-7729
Mailing Address - Country:US
Mailing Address - Phone:334-539-5391
Mailing Address - Fax:
Practice Address - Street 1:2900 E UNIVERSITY DR STE 110
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-7729
Practice Address - Country:US
Practice Address - Phone:334-539-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSE72TAC31152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist