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Individual

JOHNNY ROBERT LINDQUIST III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
48 CENTENNIAL WAY, GREENVILLE, SC 29605-4662
(864) 522-8000
(864) 522-8005
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125.069905
IL
208800000X
Urology Physician
Primary
87669
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125.069905
IL
05
876699
SC
Enumeration date
06/11/2017
Last updated
02/13/2023
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