Healthcare Provider Details

I. General information

NPI: 1669811253
Provider Name (Legal Business Name): LINDSEY ELIZABETH PORTA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY ELIZABETH SMITH MD

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11051 STATE ROAD 101
BROOKVILLE IN
47012-8836
US

IV. Provider business mailing address

1100 REID PARKWAY PAYOR ENROLLMENT
RICHMOND IN
47374
US

V. Phone/Fax

Practice location:
  • Phone: 765-547-4231
  • Fax: 765-547-1414
Mailing address:
  • Phone: 765-935-8802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01092090A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: