Basic Information
Provider Information
NPI: 1295796837
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POLLOCK
FirstName: LINDSAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
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Mailing Information
Address1: 2830 VICTORY PKWY
Address2: STE. 320
City: CINCINNATI
State: OH
PostalCode: 452061785
CountryCode: US
TelephoneNumber: 5132453335
FaxNumber: 5134757259
Practice Location
Address1: 222 PIEDMONT AVE
Address2: STE. 7000
City: CINCINNATI
State: OH
PostalCode: 452194231
CountryCode: US
TelephoneNumber: 5134758787
FaxNumber: 5134757348
Other Information
ProviderEnumerationDate: 03/31/2006
LastUpdateDate: 02/04/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X50-002055OHN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AS0400X50-002055OHY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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