Provider Demographics
NPI:1972740975
Name:DODD, LINDSAY SUE THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:SUE THOMAS
Last Name:DODD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 IMMOKALEE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1439
Mailing Address - Country:US
Mailing Address - Phone:239-513-9800
Mailing Address - Fax:
Practice Address - Street 1:2960 IMMOKALEE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1439
Practice Address - Country:US
Practice Address - Phone:239-513-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4237585OtherCIGNA ID
FL6910907OtherAETNA HMO PIN
FL22206OtherBCBS
FLK0166OtherMEDICARE GROUP ID
FL000932600Medicaid
FL9828312OtherAETNA PIN
FL9828312OtherAETNA PIN