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General NPI Number Information
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NPI Number | 1154482438
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Entity Type | Individual
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Provider Name | LINDEN R PEARSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 4230 LINCOLNSHIRE DR STE G
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2189
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Country | US
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Telephone | 618-244-6770
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Fax | 618-244-6772
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Provider Business Mailing Address
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Address Line | 4230 LINCOLNSHIRE DR STE G
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2189
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Country | US
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Telephone | 618-244-6770
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Fax | 618-244-6772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036063418
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License Number State | IL
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