Provider Demographics
NPI:1740684679
Name:BUCKINGHAM, LINDSEY KATHLEEN (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KATHLEEN
Last Name:BUCKINGHAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5056
Mailing Address - Country:US
Mailing Address - Phone:239-989-1623
Mailing Address - Fax:
Practice Address - Street 1:5731 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5056
Practice Address - Country:US
Practice Address - Phone:941-342-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108258363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical