Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0102203035 | VA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0102203035 | VA |
NPI | 1003044694 |
---|---|
Provider Name | Lindsay R Wilson |
First Address | Roanoke, VA 24017-2500 |
Second Address | Roanoke, VA 24017-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 06/01/2020 |