Provider Demographics
NPI:1255580700
Name:HUMPHREYS, LINDSEY MARIE (MD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MARIE
Other - Last Name:WESTERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-935-8747
Mailing Address - Fax:765-983-3008
Practice Address - Street 1:2330 MATTIE HARRIS RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IN
Practice Address - Zip Code:47330-9741
Practice Address - Country:US
Practice Address - Phone:937-902-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071249A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201072840Medicaid
INM400072645Medicare PIN