Basic Information
Provider Information
NPI: 1598962896
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINTON
FirstName: JULIE
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 57 CROSS PARK CT
Address2:  
City: GREENVILLE
State: SC
PostalCode: 29605
CountryCode: US
TelephoneNumber: 8642207270
FaxNumber: 8642419211
Other Information
ProviderEnumerationDate: 06/29/2007
LastUpdateDate: 06/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X2011-00935NCN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X32545SCY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
32545505SC MEDICAID


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