Basic Information
Provider Information
NPI: 1720010713
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINKER
FirstName: ROBERT
MiddleName: WILLIAM
NamePrefix:  
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 950248
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402950248
CountryCode: US
TelephoneNumber: 5024895730
FaxNumber: 5024895753
Practice Location
Address1: 4003 KRESGE WAY
Address2: 224
City: LOUISVILLE
State: KY
PostalCode: 402074652
CountryCode: US
TelephoneNumber: 5028952295
FaxNumber: 5028952296
Other Information
ProviderEnumerationDate: 07/07/2006
LastUpdateDate: 12/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000X24882KYY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

ID Information
IDTypeStateIssuerDescription
6424882605KY MEDICAID


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