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NPI Code Detail

MEDICARE: LINDSEY MEREDITH DIAZ PA-C

MEDICARE:   LINDSEY MEREDITH DIAZ  PA-C
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA60235184WA
2363A00000XPhysician AssistantPA4400CO
3363AS0400XSurgical Physician AssistantPA-602AL

General Provider Information

NPI Number : 1235389701
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY MEREDITH DIAZ PA-C
Provider Business Mailing Address
First Line : 5575 TECH CENTER DR
Second Line : SUITE 106
City : COLORADO SPRINGS
State : CO
Zip : 80919-2353
Country : US
Telephone Number : 719-548-0700
Fax Number :
Provider Business Practice Location Address
First Line : 8809 N UNION BLVD
Second Line : SUITE 200
City : COLORADO SPRINGS
State : CO
Zip : 80920
Country : US
Telephone Number : 719-548-0700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2008
Last Update Date : 05/04/2017

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Directions to “ LINDSEY MEREDITH DIAZ PA-C” Practice Location

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