MEDICARE: DR. GEORGE ALAN LINSEY O.D.

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	152W00000X	Optometrist	#OPC2745	FL

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	:	1093783920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ALAN LINSEY O.D.

Provider Business Mailing Address
First Line	:	17633 GUNN HWY
Second Line	:	STE 364
City	:	ODESSA
State	:	FL
Zip	:	33556-1912
Country	:	US
Telephone Number	:	813-960-8896
Fax Number	:	813-960-3248

Provider Business Practice Location Address
First Line	:	12964 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2806
Country	:	US
Telephone Number	:	813-960-8896
Fax Number	:	813-960-3248

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	08/23/2016

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