Healthcare Provider Details

I. General information

NPI: 1982259065
Provider Name (Legal Business Name): LYNDSAY EWING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4371 NARROW LANE RD STE 100
MONTGOMERY AL
36116-2975
US

IV. Provider business mailing address

4371 NARROW LANE RD STE 100
MONTGOMERY AL
36116-2975
US

V. Phone/Fax

Practice location:
  • Phone: 334-613-3680
  • Fax: 334-613-3685
Mailing address:
  • Phone: 334-613-3680
  • Fax: 334-613-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number2473
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2473
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: