Provider Demographics
NPI:1487634275
Name:KESSINGER, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:KESSINGER
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 1:97 GREAT TEAYS BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9816
Mailing Address - Country:US
Mailing Address - Phone:304-757-6999
Mailing Address - Fax:304-757-3252
Practice Address - Street 1:503 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:ELEANOR
Practice Address - State:WV
Practice Address - Zip Code:25070
Practice Address - Country:US
Practice Address - Phone:304-586-0001
Practice Address - Fax:304-586-1301
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15818207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001709560OtherMT. STATE
WV0042471000Medicaid
OH0839150Medicaid
WV1487634275Medicaid
WV000000178452OtherANTHEM
WV00058048OtherRR MEDICARE
KY64698137Medicaid
WV001709560OtherMT. STATE
WV2015196Medicare PIN
WVPO1434660Medicare PIN
WV000000178452OtherANTHEM
WV2015198Medicare PIN
WV2033861Medicare PIN
WV511949Medicare PIN
WV5119491Medicare PIN
WV2015199Medicare PIN
WV2015192Medicare PIN
WV2015195Medicare PIN
WV2015191Medicare PIN