Provider Demographics
NPI:1821029737
Name:GARCIA, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 71294
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-1294
Mailing Address - Country:US
Mailing Address - Phone:907-378-8119
Mailing Address - Fax:907-488-5539
Practice Address - Street 1:1405 KELLUM ST STE 201
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4189
Practice Address - Country:US
Practice Address - Phone:907-378-8119
Practice Address - Fax:907-488-5539
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK3645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD01361Medicaid
AKMD01361Medicaid
F67688Medicare UPIN