Provider Demographics
NPI:1598778722
Name:LINKOUS, HARRY ABRAHAM III (MD)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:ABRAHAM
Last Name:LINKOUS
Suffix:III
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 1:320 FOREST HILL RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4826
Mailing Address - Country:US
Mailing Address - Phone:478-474-1375
Mailing Address - Fax:478-474-1377
Practice Address - Street 1:320 FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4826
Practice Address - Country:US
Practice Address - Phone:478-474-1375
Practice Address - Fax:478-474-1377
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00404478BMedicaid
GA08BBVHTMedicare ID - Type Unspecified
GAE42080Medicare UPIN