Provider Demographics
NPI:1326487109
Name:LINCOLN, CANDY SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:SUZANNE
Last Name:LINCOLN
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:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:2325 SMILEY LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1947
Practice Address - Country:US
Practice Address - Phone:573-884-8980
Practice Address - Fax:573-884-0040
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-9609207Q00000X
MO2013017664207Q00000X
MO2022028596207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine