Provider Demographics
NPI:1689653123
Name:HA, LINDA (DO)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 ARCH ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1436
Mailing Address - Country:US
Mailing Address - Phone:330-375-3315
Mailing Address - Fax:330-375-3760
Practice Address - Street 1:55 ARCH ST STE 1B
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1436
Practice Address - Country:US
Practice Address - Phone:330-375-3315
Practice Address - Fax:330-375-3760
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-6352-H207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2069078Medicaid
OHHA0854172OtherMEDICARE ID
OH0854173OtherMEDICARE ID
OH110240822OtherRAILROAD MEDICARE
OH729115OtherBUCKEYE COMMUNITY HEALTH
OH580OtherSUMMACARE
OH000000256313OtherANTHEM
OHG67431Medicare UPIN