Healthcare Provider Details

I. General information

NPI: 1669543856
Provider Name (Legal Business Name): CLIFFORD WESLEY LINDSEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ENOTA DR NE STE 400
GAINESVILLE GA
30501-3474
US

IV. Provider business mailing address

2970 BRANDYWINE RD STE 125
ATLANTA GA
30341-5521
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-2593
  • Fax:
Mailing address:
  • Phone: 404-256-2593
  • Fax: 770-488-9479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number059459
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200401529
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: