Provider Demographics
NPI:1790792414
Name:CALHOUN, LINDA GAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GAY
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2429 WEST COMMERCE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564
Mailing Address - Country:US
Mailing Address - Phone:228-875-1141
Mailing Address - Fax:228-875-7477
Practice Address - Street 1:2429 WEST COMMERCE ST
Practice Address - Street 2:SUITE A
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:228-875-1141
Practice Address - Fax:228-875-7477
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS80136213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118186Medicaid
MS00118186Medicaid
MS480000082Medicare ID - Type Unspecified