Basic Information
Provider Information
NPI: 1497199269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINSON
FirstName: JEREMY
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 829641
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191829641
CountryCode: US
TelephoneNumber: 2673705295
FaxNumber: 2152303725
Practice Location
Address1: 599 W STATE ST STE 302
Address2:  
City: DOYLESTOWN
State: PA
PostalCode: 18901
CountryCode: US
TelephoneNumber: 2153487195
FaxNumber: 2153488633
Other Information
ProviderEnumerationDate: 04/24/2013
LastUpdateDate: 09/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XMD465315PAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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