Provider Demographics
NPI:1447514914
Name:ALLRED, LINDSEY HALLEY (MD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:HALLEY
Last Name:ALLRED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:DENISE
Other - Last Name:HALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-2695
Mailing Address - Fax:601-984-2683
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-2695
Practice Address - Fax:601-984-2683
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-25552085R0202X
MS247402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology