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NPI Code Detail

MEDICARE: LINDSEY FAUSNAUGH RD, LD

MEDICARE:   LINDSEY  FAUSNAUGH  RD, LD
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
1133V00000XRegistered Dietitian
2133V00000XRegistered DietitianLD.5920OH

General Provider Information

NPI Number : 1558582106
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY FAUSNAUGH RD, LD
Provider Business Mailing Address
First Line : PO BOX 346
Second Line :
City : MOUNT STERLING
State : OH
Zip : 43143-9059
Country : US
Telephone Number : 614-989-5058
Fax Number :
Provider Business Practice Location Address
First Line : 16703 WHITESIDE RD
Second Line :
City : MOUNT STERLING
State : OH
Zip : 43143-9059
Country : US
Telephone Number : 740-779-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 06/14/2020

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Directions to “ LINDSEY FAUSNAUGH RD, LD” Practice Location

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