Provider Demographics
NPI:1982417234
Name:DILLARD, LYNDSEY (PA-C)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:DILLARD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3528
Mailing Address - Country:US
Mailing Address - Phone:501-975-5633
Mailing Address - Fax:501-255-1461
Practice Address - Street 1:5320 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3528
Practice Address - Country:US
Practice Address - Phone:501-975-5633
Practice Address - Fax:501-227-0710
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X, 363AS0400X
ARPA-1378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical