Provider Demographics
NPI:1710964952
Name:LINKOUS, MAURICE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:D
Last Name:LINKOUS
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 1:5129 DIXIE HWY
Mailing Address - Street 2:STE. 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-1727
Mailing Address - Country:US
Mailing Address - Phone:502-447-8786
Mailing Address - Fax:502-447-8623
Practice Address - Street 1:1 AUDUBON PLAZA DR # 276
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1318
Practice Address - Country:US
Practice Address - Phone:502-447-8786
Practice Address - Fax:502-447-8623
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY333902085R0202X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200171230Medicaid
KY64333909Medicaid
IN200171230Medicaid
KY699208Medicare PIN