Provider Demographics
NPI:1093729733
Name:LINDA C. EVANS MD, LLC
Entity Type:Organization
Organization Name:LINDA C. EVANS MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-985-0950
Mailing Address - Street 1:8261 CORNELL RD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2278
Mailing Address - Country:US
Mailing Address - Phone:513-985-0950
Mailing Address - Fax:513-792-5191
Practice Address - Street 1:8261 CORNELL RD
Practice Address - Street 2:SUITE 610
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2278
Practice Address - Country:US
Practice Address - Phone:513-985-0950
Practice Address - Fax:513-792-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059278207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0913766Medicaid
OHLI9325041Medicare ID - Type Unspecified