Provider Demographics
NPI:1245444819
Name:LINDSAY, JOHN EDWARD (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2 SAINT ANTHONYS WAY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-4569
Mailing Address - Country:US
Mailing Address - Phone:618-463-0227
Mailing Address - Fax:618-463-0291
Practice Address - Street 1:2 SAINT ANTHONYS WAY
Practice Address - Street 2:SUITE 305
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4569
Practice Address - Country:US
Practice Address - Phone:618-463-0227
Practice Address - Fax:618-463-0291
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2014-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL016005267213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
K38686Medicare UPIN