Provider Demographics
NPI:1669543856
Name:LINDSEY, CLIFFORD WESLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:WESLEY
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 BRANDYWINE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5540
Mailing Address - Country:US
Mailing Address - Phone:404-256-2593
Mailing Address - Fax:770-488-9479
Practice Address - Street 1:200 S ENOTA DR NE STE 400
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3474
Practice Address - Country:US
Practice Address - Phone:404-256-2593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401529207R00000X
GA0594592080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA059459OtherGA COMPOSITE BOARD OF MEDICAL EXAMINERS
NC200401529OtherNORTH CAROLINA MEDICAL BOARD
NC200401529OtherNORTH CAROLINA MEDICAL BOARD
GA059459OtherGA COMPOSITE BOARD OF MEDICAL EXAMINERS