Provider Demographics
NPI:1104800366
Name:FRANTZ, LINDA SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SEBASTIAN
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 ONEILL HWY
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1719
Mailing Address - Country:US
Mailing Address - Phone:570-963-0977
Mailing Address - Fax:570-963-7708
Practice Address - Street 1:1039 ONEILL HWY
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1710
Practice Address - Country:US
Practice Address - Phone:570-963-0977
Practice Address - Fax:570-963-1449
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037539E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001629122Medicaid
PA110197530Medicare PIN
PA161291NW4Medicare ID - Type Unspecified
PAB40331Medicare UPIN