Healthcare Provider Details

I. General information

NPI: 1891093241
Provider Name (Legal Business Name): LINDSAY M SMITH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 WHEELER AVE
DUNMORE PA
18512-2834
US

IV. Provider business mailing address

1300 WHEELER AVE
DUNMORE PA
18512-2834
US

V. Phone/Fax

Practice location:
  • Phone: 570-348-0360
  • Fax: 570-348-0362
Mailing address:
  • Phone: 570-348-0360
  • Fax: 570-348-0362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberOS017521
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: