Provider Demographics
NPI:1316074412
Name:LINERT, KIMBERLEY ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:ANNE
Last Name:LINERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 TRIBBLE GAP RD
Mailing Address - Street 2:#1305
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-2937
Mailing Address - Country:US
Mailing Address - Phone:678-965-5558
Mailing Address - Fax:
Practice Address - Street 1:2320 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6339
Practice Address - Country:US
Practice Address - Phone:678-965-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001285152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy