Provider Demographics
NPI:1942593389
Name:LINDELL, ANDREW JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:LINDELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 US HIGHWAY 51 AND 138
Mailing Address - Street 2:SUITE E
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-2080
Mailing Address - Country:US
Mailing Address - Phone:608-205-2293
Mailing Address - Fax:608-205-6813
Practice Address - Street 1:2300 US HIGHWAY 51 AND 138
Practice Address - Street 2:SUITE E
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-2080
Practice Address - Country:US
Practice Address - Phone:608-205-2293
Practice Address - Fax:608-205-6813
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002501152W00000X
NY007816152W00000X
WI3401-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist