Provider Demographics
NPI:1013014539
Name:MCKINLEY, LINDSAY K (OD)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:K
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:K
Other - Last Name:ANNARATONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:KY
Mailing Address - Zip Code:42533-0306
Mailing Address - Country:US
Mailing Address - Phone:606-492-2211
Mailing Address - Fax:606-676-0873
Practice Address - Street 1:16605 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-6283
Practice Address - Country:US
Practice Address - Phone:423-569-9339
Practice Address - Fax:423-569-1316
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2676152W00000X
KY1675DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100010450Medicaid
PO0735672OtherRAILROAD MEDICARE FOR ONEIDA
TN3946965Medicaid
01231198OtherAMERIGROUP
TN4159461OtherTENNCARE/BLUECARE/BCBSTN
KY7100212600Medicaid
KY0880904Medicare PIN
TN4159461OtherTENNCARE/BLUECARE/BCBSTN
PO0735672OtherRAILROAD MEDICARE FOR ONEIDA
KY7100212600Medicaid