Provider Demographics
NPI:1770553448
Name:PREWITT, LINDSEY J (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:J
Last Name:PREWITT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-0668
Mailing Address - Country:US
Mailing Address - Phone:479-754-8384
Mailing Address - Fax:479-754-7141
Practice Address - Street 1:601 W MCKENNON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3523
Practice Address - Country:US
Practice Address - Phone:479-754-8384
Practice Address - Fax:479-754-7141
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR020407900OtherBLACK LUNG PROGRAM
AR141092001Medicaid
AR0790780001OtherPALMETTO GBA
AR508627OtherHEALTH LINK
AR5L601OtherBLUECROSSBLUESHIELD ARK
AR2124382OtherUNITED HEALTHCARE
ARXX12984OtherHEALTH PLUS OF MICHIGAN
AR0062731OtherUMWA H&R FUNDS
AR110214034OtherRAILROAD MEDICARE/PALMETT
AR7674194OtherAETNA INSURANCE COMPANY
AR19169000000OtherQUALCHOICE