MEDICARE: LINDSAY A WYLIE M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35.122919	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1083826093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY A WYLIE M.D.

Provider Business Mailing Address
First Line	:	4885 OLENTANGY RIVER RD
Second Line	:	SUITE 2-10
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1952
Country	:	US
Telephone Number	:	614-267-7878
Fax Number	:	614-267-7077

Provider Business Practice Location Address
First Line	:	4885 OLENTANGY RIVER RD
Second Line	:	SUITE 2-10
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1952
Country	:	US
Telephone Number	:	614-267-7878
Fax Number	:	614-267-7077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	05/23/2014

4885 OLENTANGY RIVER RD , SUITE 2-50
COLUMBUS, OH
43214-1952

Practice Phone: 614-451-1551
Practice Fax: 614-451-2326

4885 OLENTANGY RIVER RD , SUITE 1-10
COLUMBUS, OH
43214-1952