Provider Demographics
NPI:1104936830
Name:LINDSAY, BERT LAWRENCE (DC)
Entity type:Individual
Prefix:
First Name:BERT
Middle Name:LAWRENCE
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 E. INDIAN SCHOOL RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4844
Mailing Address - Country:US
Mailing Address - Phone:602-274-9988
Mailing Address - Fax:602-263-8535
Practice Address - Street 1:1095 E. INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4844
Practice Address - Country:US
Practice Address - Phone:602-274-9988
Practice Address - Fax:602-263-8535
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0232950OtherBLUE CROSS BLUE SHIELD