Basic Information
Provider Information
NPI: 1588671390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINDSEY
FirstName: HUGH
MiddleName: JEFFREY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SERVICE RD
Address2: A201
City: EAST LANSING
State: MI
PostalCode: 488247015
CountryCode: US
TelephoneNumber: 5178842976
FaxNumber: 5174323928
Practice Location
Address1: 1215 E MICHIGAN AVE
Address2:  
City: LANSING
State: MI
PostalCode: 489121811
CountryCode: US
TelephoneNumber: 5173642616
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/02/2006
LastUpdateDate: 07/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X4301054410MIY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
10420992705MI MEDICAID
158867139005MI MEDICAID
334339405MI MEDICAID
020230053101MIBCBS OF MICHIGANOTHER


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