Provider Demographics
NPI:1700058740
Name:SHARRER, LINDSAY (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:SHARRER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:BOUDREAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4010 DUPONT CIR
Practice Address - Street 2:SUITE 283
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4812
Practice Address - Country:US
Practice Address - Phone:502-897-1727
Practice Address - Fax:502-895-0827
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49892208000000X
KYTP566208000000X
KY46945208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100304290Medicaid
KY159871OtherSIHO-NCMA
KY000000869502OtherANTHEM-NCMA
KY159871OtherSIHO-NCMA