Provider Demographics
NPI:1881771186
Name:THORNTON, LINDA MARIE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:MCATEER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:994 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5122
Mailing Address - Country:US
Mailing Address - Phone:401-946-1155
Mailing Address - Fax:401-942-2303
Practice Address - Street 1:994 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5122
Practice Address - Country:US
Practice Address - Phone:401-946-1155
Practice Address - Fax:401-942-2303
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI236213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI767584OtherTUFTS
RI27-00219OtherUNITED HEALTH
RI200590OtherBLUE CHIP
RI9007030Medicaid
RI7030-2OtherBLUE CROSS
RI489007030Medicare ID - Type Unspecified
RI9007030Medicaid