Provider Demographics
NPI:1306506027
Name:LINDSEY, TITO ANDRE
Entity type:Individual
Prefix:
First Name:TITO
Middle Name:ANDRE
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 NE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-8212
Mailing Address - Country:US
Mailing Address - Phone:580-919-9434
Mailing Address - Fax:
Practice Address - Street 1:8501 NW MADISCHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-1221
Practice Address - Country:US
Practice Address - Phone:580-492-3614
Practice Address - Fax:580-492-5029
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist