MEDICARE: DR. LINDA ANN EAKLE DO

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	207Q00000X	Family Medicine Physician	WV0792	WV

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

General Provider Information

NPI Number	:	1093730624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA ANN EAKLE DO

Provider Business Mailing Address
First Line	:	1509 W MAIN STREET
Second Line	:
City	:	MILTON
State	:	WV
Zip	:	25541
Country	:	US
Telephone Number	:	304-743-7141
Fax Number	:	304-743-7143

Provider Business Practice Location Address
First Line	:	1509 W MAIN STREET
Second Line	:
City	:	MILTON
State	:	WV
Zip	:	25541
Country	:	US
Telephone Number	:	304-743-7141
Fax Number	:	304-743-7143

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	12/22/2015

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