Provider Demographics
NPI:1235124470
Name:ROBINSON, LINDA J (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:ATTN CLINIC CREDENTIALING
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:641-322-6338
Mailing Address - Fax:
Practice Address - Street 1:210 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:IA
Practice Address - Zip Code:50851-1242
Practice Address - Country:US
Practice Address - Phone:641-322-6338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0102OtherHERITAGE
1196015OtherCOVOP
IA28113OtherWELLMARK
14955OtherHCP
420870851OtherCOMMERCIAL
IA0030296Medicaid
001007OtherSECURE CARE
0100034OtherCOVPC
IA119601SOtherCOVENTRY
IA28113OtherWELLMARK
IA0102OtherHERITAGE