MEDICARE: DR. COLIN STEWART LINKE D.O.

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	208600000X	Surgery Physician	125069080	IL
2	208800000X	Urology Physician	02006233A	IN
3	208800000X	Urology Physician	305439	LA

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	:	1417318304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLIN STEWART LINKE D.O.

Provider Business Mailing Address
First Line	:	7920 W JEFFERSON BLVD STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4166
Country	:	US
Telephone Number	:	260-702-9515
Fax Number	:	260-572-2207

Provider Business Practice Location Address
First Line	:	7920 W JEFFERSON BLVD STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4166
Country	:	US
Telephone Number	:	260-702-9515
Fax Number	:	260-572-2207

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

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	09/24/2025

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