Provider Demographics
NPI:1003026097
Name:LINDKE, DOUG ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOUG
Middle Name:ROBERT
Last Name:LINDKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 CLINTON AVE N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1407
Mailing Address - Country:US
Mailing Address - Phone:585-241-9000
Mailing Address - Fax:585-454-2017
Practice Address - Street 1:87 CLINTON AVE N
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1455
Practice Address - Country:US
Practice Address - Phone:585-241-9000
Practice Address - Fax:585-454-2017
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist