Provider Demographics
NPI:1821525023
Name:WOOD, LINDSAY MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:MARIE
Last Name:WOOD
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 1:648 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2741
Mailing Address - Country:US
Mailing Address - Phone:843-697-6588
Mailing Address - Fax:
Practice Address - Street 1:1200 E MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1738
Practice Address - Country:US
Practice Address - Phone:864-585-7807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1986152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist