Healthcare Provider Details

I. General information

NPI: 1871812057
Provider Name (Legal Business Name): SCOTT W. LINDSAY, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 FARMINGTON AVE
FARMINGTON CT
06032-1573
US

IV. Provider business mailing address

196 PARKWAY S SUITE 304
WATERFORD CT
06385-1234
US

V. Phone/Fax

Practice location:
  • Phone: 860-677-7272
  • Fax: 860-677-4017
Mailing address:
  • Phone: 860-442-7027
  • Fax: 860-437-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000668
License Number StateCT

VIII. Authorized Official

Name: SCOTT W LINDSAY
Title or Position: PODIATRIST/ OWNER
Credential: DPM
Phone: 860-677-7272