Provider Demographics
NPI:1770583874
Name:LINDSEY, MARK A (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5965 E BROAD ST
Mailing Address - Street 2:#250
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1562
Mailing Address - Country:US
Mailing Address - Phone:614-759-5060
Mailing Address - Fax:614-759-5065
Practice Address - Street 1:5965 E BROAD ST
Practice Address - Street 2:#250
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1562
Practice Address - Country:US
Practice Address - Phone:614-759-5060
Practice Address - Fax:614-759-5065
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35063703208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2026815Medicaid
OH2026815Medicaid
G46959Medicare UPIN