MEDICARE: XIAO LIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	01055822A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750382586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XIAO LIN MD

Provider Business Mailing Address
First Line	:	7910 W JEFFERSON BLVD STE 110
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4159
Country	:	US
Telephone Number	:	260-436-4116
Fax Number	:	260-436-1878

Provider Business Practice Location Address
First Line	:	1440 E COUNTY LINE RD STE 1200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-0963
Country	:	US
Telephone Number	:	317-497-6270
Fax Number	:	317-497-2522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/12/2025

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Directions to “ XIAO LIN MD” Practice Location

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