Provider Demographics
NPI:1043414741
Name:LIN, TONY C (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:625 9TH AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2464
Mailing Address - Country:US
Mailing Address - Phone:360-501-3400
Mailing Address - Fax:360-423-5682
Practice Address - Street 1:625 9TH AVE
Practice Address - Street 2:STE 210
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2464
Practice Address - Country:US
Practice Address - Phone:360-501-3400
Practice Address - Fax:360-423-5682
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD29095207X00000X
WAMD60619770207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery