Provider Demographics
NPI:1841978038
Name:BLAGG, LINDSEY
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:BLAGG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 AUTUMN RD STE 275
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3745
Mailing Address - Country:US
Mailing Address - Phone:501-224-3499
Mailing Address - Fax:501-224-1140
Practice Address - Street 1:904 AUTUMN RD STE 275
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3745
Practice Address - Country:US
Practice Address - Phone:501-224-3499
Practice Address - Fax:501-224-1140
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist