Provider Demographics
NPI:1265566715
Name:EARLE, LINDA A (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:EARLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-0348
Mailing Address - Country:US
Mailing Address - Phone:215-947-2023
Mailing Address - Fax:215-947-2064
Practice Address - Street 1:8835 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2718
Practice Address - Country:US
Practice Address - Phone:610-930-9900
Practice Address - Fax:610-930-9905
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040836E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF29412Medicare UPIN
565682Medicare ID - Type Unspecified