Provider Demographics
NPI:1720042823
Name:LININGER, JOHN R (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:LININGER
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:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:559 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4250
Practice Address - Country:US
Practice Address - Phone:484-622-1435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029627E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0048025000OtherPERSONAL CHOICE/KHPE
PA0048025000OtherAMERIHEALTH/INTERCOUNTY
PA220002447OtherRRM
PA0009377700001Medicaid
PA1029017OtherKEYSTONE MERCY HP
PA350758OtherPHCS
PA169375OtherHIGHMARK BLUE SHIELD
PA0093777001OtherAMERICHOICE
PA3250775OtherCIGNA HMO/PPO
PAMD029627EOtherHEALTH PARTNERS
PA0009377700001Medicaid
PA169375Medicare ID - Type UnspecifiedHMN MODIFIER FOR PGF