Provider Demographics
NPI:1255466223
Name:LINDER, MARK W (PHD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:LINDER
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:201 E JEFFERSON ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1246
Mailing Address - Country:US
Mailing Address - Phone:502-569-1584
Mailing Address - Fax:502-569-1585
Practice Address - Street 1:201 E JEFFERSON ST
Practice Address - Street 2:SUITE 309
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1246
Practice Address - Country:US
Practice Address - Phone:502-569-1584
Practice Address - Fax:502-569-1585
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2008-04-03
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4017401Medicare PIN