Provider Demographics
NPI:1336128677
Name:LINABERY, LINFERD G JR (MD)
Entity Type:Individual
Prefix:
First Name:LINFERD
Middle Name:G
Last Name:LINABERY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 E ASHMAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-4066
Mailing Address - Country:US
Mailing Address - Phone:989-631-9140
Mailing Address - Fax:989-631-7227
Practice Address - Street 1:1715 E ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-4066
Practice Address - Country:US
Practice Address - Phone:989-631-9140
Practice Address - Fax:989-631-7227
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILL026402207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2032728Medicaid
MI1805628802OtherBLUE CROSS BLUE SHIELD
MI1805628802OtherBLUE CROSS BLUE SHIELD
MI05628805182Medicare ID - Type Unspecified