Provider Demographics
NPI:1255518387
Name:LINDSAY, CARLA RENEE (OD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:RENEE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3435 ROCK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2471
Mailing Address - Country:US
Mailing Address - Phone:770-355-1202
Mailing Address - Fax:
Practice Address - Street 1:1281 SOUTHLAKE CIR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2352
Practice Address - Country:US
Practice Address - Phone:770-961-2998
Practice Address - Fax:770-961-0110
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist