Provider Demographics
NPI:1366709727
Name:HARDY, LINDSEY NICOLE (OD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:NICOLE
Last Name:HARDY
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 1:631 E TIPTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-3519
Mailing Address - Country:US
Mailing Address - Phone:812-522-4444
Mailing Address - Fax:812-522-2634
Practice Address - Street 1:631 E TIPTON ST STE 2
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3519
Practice Address - Country:US
Practice Address - Phone:812-522-4444
Practice Address - Fax:812-522-2634
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003717A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201086900Medicaid
IN000000780599OtherANTHEM BCBS
IN201086900Medicaid
IN5419240014Medicare NSC
IN5419240013Medicare NSC
KYK182970Medicare PIN