Provider Demographics
NPI:1912194549
Name:LORENE H LINDLEY MD PC
Entity Type:Organization
Organization Name:LORENE H LINDLEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENE
Authorized Official - Middle Name:H
Authorized Official - Last Name:LINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-664-8818
Mailing Address - Street 1:PO BOX 1414
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83877-1414
Mailing Address - Country:US
Mailing Address - Phone:208-664-8818
Mailing Address - Fax:208-664-4427
Practice Address - Street 1:13859 N REFLECTION RD
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858-6038
Practice Address - Country:US
Practice Address - Phone:208-664-8818
Practice Address - Fax:208-664-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00221608OtherRAILROAD MEDICARE
ID72645OtherBLUE CROSS OF IDAHO
ID807019500Medicaid
ID000010148711OtherREGENCE BLUE SHIELD