Healthcare Provider Details

I. General information

NPI: 1417955428
Provider Name (Legal Business Name): TIMOTHY JAMES LINKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 TYLERSVILLE RD SUITE 12
MASON OH
45040-1236
US

IV. Provider business mailing address

476 CHERRY HILL LN
LEBANON OH
45036-8325
US

V. Phone/Fax

Practice location:
  • Phone: 513-701-5510
  • Fax: 513-701-5511
Mailing address:
  • Phone: 513-228-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35076907L
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35076907
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: