Provider Demographics
NPI:1013917426
Name:LINEHAN, RON (MD)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:LINEHAN
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 1:200 NORTHLAND BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3604
Mailing Address - Country:US
Mailing Address - Phone:513-672-4128
Mailing Address - Fax:513-672-4479
Practice Address - Street 1:1533 ELECTION HOUSE RD NW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9059
Practice Address - Country:US
Practice Address - Phone:740-689-9500
Practice Address - Fax:740-689-9555
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060102207L00000X
OHBL5196628208VP0014X
OH35-060102208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2058973Medicaid
F56041Medicare UPIN
OH0841542Medicare PIN