Provider Demographics
NPI:1871506071
Name:LINDENMAN, CORY A (OD)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:A
Last Name:LINDENMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 E 9TH
Mailing Address - Street 2:WINFIELD OPTOMETRY
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156
Mailing Address - Country:US
Mailing Address - Phone:620-221-2015
Mailing Address - Fax:620-221-2466
Practice Address - Street 1:3000 E 9TH
Practice Address - Street 2:STE B
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3441
Practice Address - Country:US
Practice Address - Phone:620-221-2015
Practice Address - Fax:620-221-2466
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS1689152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200271330AMedicaid
V02411Medicare UPIN
KS200271330AMedicaid