Provider Demographics
NPI:1548478191
Name:KILLINGSWORTH, LINDSAY B (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:B
Last Name:KILLINGSWORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5780 PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-1224
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:1505 NORTHSIDE BLVD
Practice Address - Street 2:SUITE 2400
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7623
Practice Address - Country:US
Practice Address - Phone:770-888-0188
Practice Address - Fax:770-888-3358
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2013-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL27955207V00000X
GA67782207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003130203AMedicaid
GA003130203BMedicaid
GA003130203CMedicaid
GA003130203BMedicaid