Provider Demographics
NPI:1124062229
Name:SAUNDERS, LINDA JO (MD)
Entity type:Individual
Prefix:
First Name:LINDA JO
Middle Name:
Last Name:SAUNDERS
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 1:102 BUTLER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5943
Mailing Address - Country:US
Mailing Address - Phone:404-680-5375
Mailing Address - Fax:
Practice Address - Street 1:4889 GOLDEN PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5877
Practice Address - Country:US
Practice Address - Phone:678-714-3217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031118207P00000X
GA31118208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000383292DMedicaid
GA000383292EMedicaid
GAE83608Medicare UPIN
GA000383292DMedicaid