Provider Demographics
NPI:1588692743
Name:JAMES, LINDSEY KAE (OD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KAE
Last Name:JAMES
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 1:1482 S BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5752
Mailing Address - Country:US
Mailing Address - Phone:405-715-3937
Mailing Address - Fax:405-715-3938
Practice Address - Street 1:1482 S BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5752
Practice Address - Country:US
Practice Address - Phone:405-715-3937
Practice Address - Fax:405-715-3938
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2424152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200106360AMedicaid