Basic Information
| Provider Information | |||||||||
| NPI: | 1851947717 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COMBS | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 959 | ||||||||
| Address2: | |||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417020959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064360711 | ||||||||
| FaxNumber: | 6064351322 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 BLACK GOLD BLVD STE 106 | ||||||||
| Address2: | |||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417012620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064360711 | ||||||||
| FaxNumber: | 6064360848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2019 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA2539 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.