Healthcare Provider Details

I. General information

NPI: 1811978919
Provider Name (Legal Business Name): WAYNE C LINDSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 AVENIDA DE MESILLA
LAS CRUCES NM
88005-3101
US

IV. Provider business mailing address

PO BOX 1560
LAS CRUCES NM
88004-1560
US

V. Phone/Fax

Practice location:
  • Phone: 505-525-3535
  • Fax: 505-524-1654
Mailing address:
  • Phone: 505-647-8366
  • Fax: 505-647-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number20020467
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: