Provider Demographics
NPI:1861155665
Name:COLEY, LINDSEY MICHELLE (OD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:COLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11289 PARKSIDE DR SPC 1108
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1964
Mailing Address - Country:US
Mailing Address - Phone:865-675-2524
Mailing Address - Fax:865-675-2558
Practice Address - Street 1:11289 PARKSIDE DR SPC 1108
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1964
Practice Address - Country:US
Practice Address - Phone:865-675-2524
Practice Address - Fax:865-675-2558
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3719152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist