Provider Demographics
NPI:1275560146
Name:LANCASTER, LINDA JAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JAN
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 PINE ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-7880
Mailing Address - Country:US
Mailing Address - Phone:850-622-5955
Mailing Address - Fax:
Practice Address - Street 1:VA GULF COAST HEALTHCARE SYSTEM
Practice Address - Street 2:101 VERNON AVE. BLDG 387
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-7018
Practice Address - Country:US
Practice Address - Phone:850-636-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 854992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry