Provider Demographics
NPI:1952621146
Name:LINDSEY, DALE R (PA)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:R
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 SKYLINE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3911
Mailing Address - Country:US
Mailing Address - Phone:731-427-7888
Mailing Address - Fax:731-265-4159
Practice Address - Street 1:569 SKYLINE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3911
Practice Address - Country:US
Practice Address - Phone:731-427-7888
Practice Address - Fax:731-265-4159
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN785363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant