Healthcare Provider Details

I. General information

NPI: 1205992237
Provider Name (Legal Business Name): MICHELE D LINDSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WISCONSIN AMERICAN DR
FOND DU LAC WI
54937-2999
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-3129
US

V. Phone/Fax

Practice location:
  • Phone: 920-907-7000
  • Fax:
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number54011
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: