Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 10167 | WV |
NPI | 1013150093 |
---|---|
Provider Name | Dr. Richard David Lindsay |
First Address | Charleston, WV 25301-2908 |
Second Address | Charleston, WV 25301-2908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 07/04/2009 |