Provider Demographics
NPI:1053826008
Name:TOM, LINDSAY R (PA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:R
Last Name:TOM
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Gender:
Credentials:PA
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Mailing Address - Street 1:1860 TOWN CENTER DR STE 130
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5898
Mailing Address - Country:US
Mailing Address - Phone:703-689-2050
Mailing Address - Fax:
Practice Address - Street 1:1860 TOWN CENTER DR STE 130
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5898
Practice Address - Country:US
Practice Address - Phone:703-689-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2025-03-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant