Provider Demographics
NPI:1043210636
Name:GOLD, LINSEY P (DO)
Entity Type:Individual
Prefix:DR
First Name:LINSEY
Middle Name:P
Last Name:GOLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:LINSEY
Other - Middle Name:P
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2486 NERREDIA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4807
Mailing Address - Country:US
Mailing Address - Phone:810-720-9900
Mailing Address - Fax:810-720-0011
Practice Address - Street 1:2486 NERREDIA ST
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4807
Practice Address - Country:US
Practice Address - Phone:810-720-9900
Practice Address - Fax:810-720-0011
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014735208600000X
MDH62874208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0141526OtherTOTAL HEALTH CARE
MI4870778Medicaid
MI38879OtherHEALTH PLAN OF MICHIGAN
MIP00738966OtherRAIL ROAD MEDICARE
MI0141526OtherTOTAL HEALTH CARE
MIP00738966OtherRAIL ROAD MEDICARE