Healthcare Provider Details

I. General information

NPI: 1003711292
Provider Name (Legal Business Name): LINDSAY ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY BATES RD

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W BROAD AVE
WHIGHAM GA
39897-0105
US

IV. Provider business mailing address

PO BOX 105
WHIGHAM GA
39897-0105
US

V. Phone/Fax

Practice location:
  • Phone: 229-977-8015
  • Fax:
Mailing address:
  • Phone: 229-977-8015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD003711
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: