Basic Information
Provider Information
NPI: 1972193472
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOLLAR
FirstName: LINDSEY
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3889
Address2:  
City: JOHNSON CITY
State: TN
PostalCode: 376023889
CountryCode: US
TelephoneNumber: 4237942457
FaxNumber: 4232839480
Practice Location
Address1: 314 ROGOSIN DR
Address2:  
City: ELIZABETHTON
State: TN
PostalCode: 376432904
CountryCode: US
TelephoneNumber: 4234336630
FaxNumber: 4232328574
Other Information
ProviderEnumerationDate: 01/19/2021
LastUpdateDate: 05/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X4377TNY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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