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Individual

DR. WILLIAM JERRY LINDAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
26771 W 12 MILE RD, SUITE 100, SOUTHFIELD, MI 48034-1539
(248) 263-4900
(248) 263-4903
Mailing address
26771 W 12 MILE RD, SUITE 100, SOUTHFIELD, MI 48034-1539
(248) 263-4900
(248) 263-4903

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002652
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5088773
MI
01
900F367240
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
12/02/2006
Last updated
07/09/2012
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