Healthcare Provider Details

I. General information

NPI: 1881708063
Provider Name (Legal Business Name): LINTON L KUCHLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 SPRING ST NE
GAINESVILLE GA
30501-3715
US

IV. Provider business mailing address

PO BOX 3293
INDIANAPOLIS IN
46206-3293
US

V. Phone/Fax

Practice location:
  • Phone: 770-538-7828
  • Fax: 423-892-5838
Mailing address:
  • Phone: 800-346-1181
  • Fax: 423-424-3879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number30126
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number30126
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number30126
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number30126
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number30126
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: