Provider Demographics
NPI:1255779906
Name:FYKE, LINDSEY ACCARDO (PT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ACCARDO
Last Name:FYKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:ACCARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:878 AVERY BLVD N
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-5205
Mailing Address - Country:US
Mailing Address - Phone:601-957-1223
Mailing Address - Fax:601-957-7899
Practice Address - Street 1:878 AVERY BLVD N
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5205
Practice Address - Country:US
Practice Address - Phone:601-957-1223
Practice Address - Fax:601-957-7899
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist