Provider Demographics
NPI:1861535247
Name:NEESE, LYNDSEY D (MD)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:D
Last Name:NEESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:NEESE
Other - Last Name:YOUNGBLOOD
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 1:4123 DUTCHMANS LN
Practice Address - Street 2:SUITE 515
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-629-2030
Practice Address - Fax:502-629-2070
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42493207V00000X, 207V00000X
IN01067170A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000023036SOtherHUMANA - WS
KY7100072880OtherMEDICAID KY - WS
KY105737OtherSIHO - WS
KY4849132OtherCIGNA - WS
IN200958320Medicaid
KY000000621161OtherANTHEM - WS
KYP00912080OtherRAILROAD MEDICARE
KY00533141OtherMEDICARE - KY - WS
KY50024842OtherPASSPORT - WS
INP00912101OtherRAILROAD MEDICARE
KYP00912080OtherRAILROAD MEDICARE
KYP00912080OtherRAILROAD MEDICARE