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1770553448

NPI Code Detail

MEDICARE: DR. LINDSEY J PREWITT M.D.

MEDICARE: DR. LINDSEY J PREWITT M.D.

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	207R00000X	Internal Medicine Physician	E2721	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	110214034	OTHER	AR	RAILROAD MEDICARE/PALMETT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020407900	OTHER	AR	BLACK LUNG PROGRAM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0790780001	OTHER	AR	PALMETTO GBA
4	508627	OTHER	AR	HEALTH LINK
5	5L601	OTHER	AR	BLUECROSSBLUESHIELD ARK
6	2124382	OTHER	AR	UNITED HEALTHCARE
7	XX12984	OTHER	AR	HEALTH PLUS OF MICHIGAN
8	0062731	OTHER	AR	UMWA H&R FUNDS
10	7674194	OTHER	AR	AETNA INSURANCE COMPANY
11	19169000000	OTHER	AR	QUALCHOICE

General Provider Information

NPI Number	:	1770553448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDSEY J PREWITT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 668
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-0668
Country	:	US
Telephone Number	:	479-754-8384
Fax Number	:	479-754-7141

Provider Business Practice Location Address
First Line	:	601 W MCKENNON ST
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-3523
Country	:	US
Telephone Number	:	479-754-8384
Fax Number	:	479-754-7141

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/28/2025

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Directions to “ DR. LINDSEY J PREWITT M.D.” Practice Location

Language	Start Address	Practice Location

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