Provider Demographics
NPI:1386698868
Name:LINKOUS, C. LYNN (MD)
Entity type:Individual
Prefix:
First Name:C.
Middle Name:LYNN
Last Name:LINKOUS
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 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-395-8805
Mailing Address - Fax:740-395-8855
Practice Address - Street 1:280 PATTONSVILLE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9452
Practice Address - Country:US
Practice Address - Phone:740-395-8805
Practice Address - Fax:740-395-8855
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-9974207RC0000X
WV10301207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
001714050OtherMOUNTAIN STATE BCBS
OH310917085116OtherOH MEDICAID CARESOURCE
OH0566418OtherMOLINA MEDICAID
000000006626OtherANTHEM BCBS
OH000000185307OtherUNISON MEDICAID
WV0084825000Medicaid
OH0566418Medicaid
060018482OtherRR MEDICARE
OH310917085116OtherOH MEDICAID CARESOURCE
001714050OtherMOUNTAIN STATE BCBS
OH0555385Medicare PIN