Provider Demographics
NPI:1790003432
Name:HALL, LINDSEY (MD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 ODONOVAN DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4691
Mailing Address - Country:US
Mailing Address - Phone:225-769-7546
Mailing Address - Fax:225-769-0471
Practice Address - Street 1:5326 ODONOVAN DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4691
Practice Address - Country:US
Practice Address - Phone:225-769-7546
Practice Address - Fax:225-769-0471
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206178207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA345473YT1EMedicare PIN