Provider Demographics
NPI:1720111727
Name:LINDA ROCKHOLD, MD, PA
Entity type:Organization
Organization Name:LINDA ROCKHOLD, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROCKHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-362-6900
Mailing Address - Street 1:971 LAKELAND DR
Mailing Address - Street 2:STE 1157
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4643
Mailing Address - Country:US
Mailing Address - Phone:601-362-6900
Mailing Address - Fax:601-362-6111
Practice Address - Street 1:971 LAKELAND DR
Practice Address - Street 2:STE 1157
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4643
Practice Address - Country:US
Practice Address - Phone:601-362-6900
Practice Address - Fax:601-362-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSDB2168OtherRAILROAD MEDICARE
MS08527506Medicaid
MSDB2168OtherRAILROAD MEDICARE