Basic Information
Provider Information
NPI: 1518979111
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIN
FirstName: STEVE
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 936
Address2:  
City: LONDON
State: KY
PostalCode: 407430936
CountryCode: US
TelephoneNumber: 6063307818
FaxNumber: 6063307825
Practice Location
Address1: 1401 HARRODSBURG RD
Address2: SUITE A300
City: LEXINGTON
State: KY
PostalCode: 405043751
CountryCode: US
TelephoneNumber: 8592764429
FaxNumber: 8592765902
Other Information
ProviderEnumerationDate: 08/12/2006
LastUpdateDate: 05/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X35935KYN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207UN0901X35935KYN Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
207RI0011X35935KYY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
64040317 (KOHMG)05KY MEDICAID


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