Doctor Name: | RONALD LINDQUIST |
NPI Number: | 1073698031 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | 003926 |
Business Practice Address: | 112 Mimosa Dr Thomasville, GA - 317926605 |
Business Phone Number: | 2292270045 |
Business Fax Number: | 2292279120 |
Mailing Address: | 112 Mimosa Dr, THOMASVILLE |
State: | GA |
Postal Code: | 317926605 |
Phone Number: | 2292270045 |
Fax Number: | 2292279120 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 11/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 003926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |