Healthcare Provider Details

I. General information

NPI: 1942286125
Provider Name (Legal Business Name): TAMMY JEAN LINDSAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 BROWN RD
VAN BUREN MO
63965-6258
US

IV. Provider business mailing address

PO BOX 83
VAN BUREN MO
63965-0083
US

V. Phone/Fax

Practice location:
  • Phone: 618-570-1505
  • Fax: 949-577-4074
Mailing address:
  • Phone: 618-570-1505
  • Fax: 949-577-4074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-114307
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014012160
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: