Basic Information
| Provider Information | |||||||||
| NPI: | 1003147323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLARK | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | DOLAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4488 BEILMAN CT | ||||||||
| Address2: | |||||||||
| City: | HAMBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140757807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164320105 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5959 BIG TREE RD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141272291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168214400 | ||||||||
| FaxNumber: | 7168292138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2010 | ||||||||
| LastUpdateDate: | 08/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2479541 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.