Healthcare Provider Details

I. General information

NPI: 1184681025
Provider Name (Legal Business Name): LEARIE RONALD LINDSAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 PRESTON HWY
LOUISVILLE KY
40219-1820
US

IV. Provider business mailing address

215 GRAND AVE SOUTH DADE NEONATOLOGY
CORAL GABLES FL
33133-4841
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-5502
  • Fax: 502-721-8670
Mailing address:
  • Phone: 718-916-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number1097
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME113567
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50935
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: