Provider Demographics
NPI:1023338316
Name:MCMORROW, LYNDSY JEAN (DO)
Entity type:Individual
Prefix:DR
First Name:LYNDSY
Middle Name:JEAN
Last Name:MCMORROW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LYNDSY
Other - Middle Name:JEAN
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9249 W LAKE CITY RD
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9602
Mailing Address - Country:US
Mailing Address - Phone:989-422-5122
Mailing Address - Fax:989-422-4378
Practice Address - Street 1:9249 W LAKE CITY RD
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-9602
Practice Address - Country:US
Practice Address - Phone:989-422-5122
Practice Address - Fax:989-422-4378
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021518208000000X
OH34-010889208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0085115Medicaid
OHH201980Medicare PIN