Provider Demographics
NPI:1083340673
Name:CALVERT, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CALVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-1022
Mailing Address - Country:US
Mailing Address - Phone:937-483-4189
Mailing Address - Fax:
Practice Address - Street 1:1050 OLD US 52
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:45157-9773
Practice Address - Country:US
Practice Address - Phone:513-553-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker