Provider Demographics
NPI:1194263202
Name:MCCORMICK, LINDSEY (DO)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3432
Mailing Address - Country:US
Mailing Address - Phone:251-949-3479
Mailing Address - Fax:251-949-3434
Practice Address - Street 1:200 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3432
Practice Address - Country:US
Practice Address - Phone:251-968-7379
Practice Address - Fax:251-968-5960
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.2242207Q00000X
MST-3272390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL254554Medicaid