Provider Demographics
NPI:1710958293
Name:LINDER, WALTER JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:JAY
Last Name:LINDER
Suffix:
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 1:604 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:KINSLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67547-2329
Mailing Address - Country:US
Mailing Address - Phone:620-659-2732
Mailing Address - Fax:620-659-3850
Practice Address - Street 1:604 W 8TH ST
Practice Address - Street 2:
Practice Address - City:KINSLEY
Practice Address - State:KS
Practice Address - Zip Code:67547-2329
Practice Address - Country:US
Practice Address - Phone:620-659-2732
Practice Address - Fax:620-659-3850
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3104207Q00000X
KS0435403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101665102Medicaid
TX81515GOtherBCBS
TX101665102Medicaid
TX81515GOtherBCBS