Provider Demographics
NPI:1033541735
Name:KIMBERLEY A LINERT, INC
Entity Type:Organization
Organization Name:KIMBERLEY A LINERT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LINERT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-234-5773
Mailing Address - Street 1:525 TRIBBLE GAP RD
Mailing Address - Street 2:#1305
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-2937
Mailing Address - Country:US
Mailing Address - Phone:404-234-5773
Mailing Address - Fax:
Practice Address - Street 1:525 TRIBBLE GAP RD
Practice Address - Street 2:#1305
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-2937
Practice Address - Country:US
Practice Address - Phone:404-234-5773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001285152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty