Provider Demographics
NPI:1194073528
Name:BREWER, LINDSEY (OD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 BIENVILLE BLVD
Mailing Address - Street 2:C321
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5732
Mailing Address - Country:US
Mailing Address - Phone:228-875-6658
Mailing Address - Fax:228-875-0809
Practice Address - Street 1:1850 POPPS FERRY RD
Practice Address - Street 2:C321
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2059
Practice Address - Country:US
Practice Address - Phone:231-629-1128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8034T152W00000X
MS913152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist