Healthcare Provider Details
I. General information
NPI: 1740005594
Provider Name (Legal Business Name): LINDLEY HIGHAM OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1135 W UNIVERSITY DR STE 155
ROCHESTER MI
48307-1871
US
IV. Provider business mailing address
1135 W UNIVERSITY DR STE 155
ROCHESTER MI
48307-1871
US
V. Phone/Fax
- Phone: 248-710-2325
- Fax:
- Phone: 248-710-2325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 4901005848 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: