Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 73415 | GA |
N | 208600000X | Surgeon | 73415 | GA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 73415 | GA |
NPI | 1285869867 |
---|---|
Provider Name | Dr. Lindsey Wong Webb |
First Address | Atlanta, GA 30342-1749 |
Second Address | Atlanta, GA 30342-1749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 24/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003159455B | (05) | GA |