Provider Demographics
NPI:1184653727
Name:LINGER, ROBERT THOMAS JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:LINGER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3100 MACCORKLE AVENUE SE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304
Mailing Address - Country:US
Mailing Address - Phone:304-343-9588
Mailing Address - Fax:304-343-9800
Practice Address - Street 1:3100 MACCORKLE AVENUE SE
Practice Address - Street 2:SUITE 311
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-343-9588
Practice Address - Fax:304-343-9800
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV12310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4328889OtherAETNA
WV0056573000Medicaid
4328889OtherAETNA
A72191Medicare UPIN