=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952380545
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLOTTA MARVETTE LINDSAY M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2006
-----------------------------------------------------
Last Update Date | 08/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9377 N US HIGHWAY 301
-----------------------------------------------------
City | WHITAKERS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27891-8621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-437-9211
-----------------------------------------------------
Fax | 252-437-9774
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9377 N US HIGHWAY 301
-----------------------------------------------------
City | WHITAKERS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27891-8621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-437-9211
-----------------------------------------------------
Fax | 252-437-9774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD068327L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD068327-L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 2014-01372
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------