Provider Demographics
NPI:1780209726
Name:MIDDLETON, LINDSAY K
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:K
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957-1024
Mailing Address - Country:US
Mailing Address - Phone:573-223-4235
Mailing Address - Fax:
Practice Address - Street 1:420 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1024
Practice Address - Country:US
Practice Address - Phone:573-223-4235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015021158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist