Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 00009709 | AL |
NPI | 1033104500 |
---|---|
Provider Name | Rollins Lynne Tindell JR. |
First Address | Mobile, AL 36606-2457 |
Second Address | Mobile, AL 36606-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0810063 | UNITED HEALTHCARE PROV. # (01) | AL |
4006775 | AETNA PROVIDER # (01) | AL |
51034511 | BLUE CROSS PROVIDER # (01) | AL |
C75271 | (02) | |
C75271 | HEALTHSPRING PROVIDER # (01) | AL |