Healthcare Provider Details

I. General information

NPI: 1255489613
Provider Name (Legal Business Name): H. EUGENE LINDSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 WORCESTER ST
WELLESLEY MA
02481-5420
US

IV. Provider business mailing address

147 MILK ST
BOSTON MA
02109-4806
US

V. Phone/Fax

Practice location:
  • Phone: 617-431-5400
  • Fax:
Mailing address:
  • Phone: 617-421-2508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number34424
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: