MEDICARE: LINDSEY D BIRD

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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1235412271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY D BIRD

Provider Business Mailing Address
First Line	:	1317 KENILWORTH RD
Second Line	:
City	:	NICHOLS HILLS
State	:	OK
Zip	:	73120-1410
Country	:	US
Telephone Number	:	405-824-6649
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 KENILWORTH RD
Second Line	:
City	:	NICHOLS HILLS
State	:	OK
Zip	:	73120-1410
Country	:	US
Telephone Number	:	405-824-6649
Fax Number	:

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

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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Directions to “ LINDSEY D BIRD ” Practice Location

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