Healthcare Provider Details

I. General information

NPI: 1912194549
Provider Name (Legal Business Name): LORENE H LINDLEY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13859 N REFLECTION RD
RATHDRUM ID
83858-6038
US

IV. Provider business mailing address

PO BOX 1414
POST FALLS ID
83877-1414
US

V. Phone/Fax

Practice location:
  • Phone: 208-664-8818
  • Fax: 208-664-4427
Mailing address:
  • Phone: 208-664-8818
  • Fax: 208-664-4427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LORENE H LINDLEY
Title or Position: PHYSICIAN
Credential: MD
Phone: 208-664-8818