Provider Demographics
NPI:1972518546
Name:DANSBY, LINDA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:DANSBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5442
Mailing Address - Country:US
Mailing Address - Phone:334-749-6523
Mailing Address - Fax:334-742-0242
Practice Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5442
Practice Address - Country:US
Practice Address - Phone:334-749-6523
Practice Address - Fax:334-742-0242
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15215207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51028304OtherBCBS OPELIKA
AL528701590Medicaid
AL51036111OtherBCBS LAFAYETTE
AL51520917OtherBCBS AUBURN
AL1972518546OtherNPI
AL51028303OtherBCBS LANGDALE
AL51028305OtherBCBS DADEVILLE
AL51028302OtherBCBS TUSKEGEE
AL000028305Medicaid
ALCC1726OtherRRMC
E44247Medicare UPIN
000028304Medicare ID - Type UnspecifiedOPELIKA
ALCC1726OtherRRMC
AL51028304OtherBCBS OPELIKA
AL51028303OtherBCBS LANGDALE
AL528701590Medicaid
000036111Medicare ID - Type UnspecifiedLAFAYETTE