MEDICARE: MICKEY W. LINDSEY D.D.S.,P.A.

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	261QS0112X	Oral and Maxillofacial Surgery Clinic/Center	2816	AR

Other Identifiers

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

General Provider Information

NPI Number	:	1518233691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICKEY W. LINDSEY D.D.S.,P.A.

Provider Business Mailing Address
First Line	:	1920 W WASHINGTON ST
Second Line	:	SUITE A
City	:	CAMDEN
State	:	AR
Zip	:	71701-3134
Country	:	US
Telephone Number	:	870-836-7860
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 W WASHINGTON ST
Second Line	:	SUITE A
City	:	CAMDEN
State	:	AR
Zip	:	71701-3134
Country	:	US
Telephone Number	:	870-836-7860
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICKEY W LINDSEY
Credential	:	D.D.S
Telephone Number	:	870-836-7860

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	03/22/2012

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