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General NPI Number Information
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NPI Number | 1831393305
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Entity Type | Individual
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Provider Name | LINDA MCKINNON D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1745 PHOENIX BLVD STE 240
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City | COLLEGE PARK
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State | GA
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Zip | 30349-5534
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Country | US
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Telephone | 404-507-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 2657 LENOX RD NE UNIT P-216
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City | ATLANTA
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State | GA
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Zip | 30324-3191
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Country | US
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Telephone | 404-290-9587
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 046551
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License Number State | GA
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