Provider Demographics
NPI:1861487126
Name:LINDSEY, CHARLES H (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:H
Last Name:LINDSEY
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 1:2020 KAY ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1625
Mailing Address - Country:US
Mailing Address - Phone:423-581-0360
Mailing Address - Fax:423-317-6581
Practice Address - Street 1:3001 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3614
Practice Address - Country:US
Practice Address - Phone:423-581-0360
Practice Address - Fax:423-317-6581
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000011496207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3175242Medicaid
TN3712354Medicare PIN
TN3712353Medicare PIN
B03683Medicare UPIN
TN3175244Medicare ID - Type Unspecified