Basic Information
Provider Information
NPI: 1811978919
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINDSEY
FirstName: WAYNE
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1560
Address2:  
City: LAS CRUCES
State: NM
PostalCode: 880041560
CountryCode: US
TelephoneNumber: 5056478366
FaxNumber: 5056478381
Practice Location
Address1: 675 AVENIDA DE MESILLA
Address2:  
City: LAS CRUCES
State: NM
PostalCode: 880053101
CountryCode: US
TelephoneNumber: 5055253535
FaxNumber: 5055241654
Other Information
ProviderEnumerationDate: 11/07/2005
LastUpdateDate: 11/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X20020467NMY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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