Provider Demographics
NPI:1134856917
Name:LINDGREN, SPENCER DAVID (PHARMD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:DAVID
Last Name:LINDGREN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 ASPIRE CT APT 307
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-5663
Mailing Address - Country:US
Mailing Address - Phone:815-871-1161
Mailing Address - Fax:
Practice Address - Street 1:5349 W PIKE PLAZA RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3011
Practice Address - Country:US
Practice Address - Phone:317-387-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029781A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist