| Ethan D Lindsey Md Pc | |
|
1117 Nw 50th St Oklahoma City OK 73118-4401 | |
| (405) 842-4435 | |
| (405) 842-2846 |
| Full Name | Ethan D Lindsey Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1117 Nw 50th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Ethan David Lindsey (PRESIDENT) |
| Authorized Official Contact | 4058424435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan D Lindsey Md Pc 1117 Nw 50th St Oklahoma City OK 73118-4401 Ph: (405) 842-4435 | Ethan D Lindsey Md Pc 1117 Nw 50th St Oklahoma City OK 73118-4401 Ph: (405) 842-4435 |
| NPI Number | 1013049170 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 9830376383 |
|---|---|
| Medicare Enrollment ID | O20110609000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013049170 | NPI | - | NPPES |
| 100130670C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 16538 (Oklahoma) | Primary |
| Provider Name | Ethan D Lindsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033103304 PECOS PAC ID: 8527128859 Enrollment ID: I20081117000660 |
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