Provider Demographics
NPI:1649293184
Name:LINDSAY, DOREEN LYNNETTE (DO)
Entity type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:LYNNETTE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DOREEN
Other - Middle Name:LYNNETTE
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7934 WOODCHASE DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-5006
Mailing Address - Country:US
Mailing Address - Phone:215-800-7885
Mailing Address - Fax:
Practice Address - Street 1:353 FAIRMONT BLVD.
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:605-719-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1763207QA0505X, 208M00000X
SD8293207Q00000X
KYC0707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist