Provider Demographics
NPI:1932216439
Name:ORLEANS-LINDSAY, KODWO KUNTU (MD)
Entity Type:Individual
Prefix:DR
First Name:KODWO
Middle Name:KUNTU
Last Name:ORLEANS-LINDSAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3634
Mailing Address - Country:US
Mailing Address - Phone:901-272-7200
Mailing Address - Fax:901-260-5916
Practice Address - Street 1:1417 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3634
Practice Address - Country:US
Practice Address - Phone:901-272-7200
Practice Address - Fax:901-260-5916
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3333899Medicaid
TN39513OtherTN MEDICAL LICENSE
TN3333899Medicaid
TN3333899Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER