Healthcare Provider Details

I. General information

NPI: 1902921976
Provider Name (Legal Business Name): REGINA S LINDSEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4772 NAVY RD
MILLINGTON TN
38053-1927
US

IV. Provider business mailing address

PO BOX 279 4772 NAVY ROAD
MILLINGTON TN
38083-0279
US

V. Phone/Fax

Practice location:
  • Phone: 901-873-4501
  • Fax: 901-873-4505
Mailing address:
  • Phone: 901-873-4501
  • Fax: 901-873-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000018070
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: