Provider Demographics
NPI:1902801319
Name:LINARD, HOMER C (DO)
Entity Type:Individual
Prefix:
First Name:HOMER
Middle Name:C
Last Name:LINARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28100 GRAND RIVER AVE
Mailing Address - Street 2:STE 209
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5969
Mailing Address - Country:US
Mailing Address - Phone:248-474-5575
Mailing Address - Fax:248-474-4679
Practice Address - Street 1:28100 GRAND RIVER AVE
Practice Address - Street 2:STE 209
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5969
Practice Address - Country:US
Practice Address - Phone:248-474-5575
Practice Address - Fax:248-474-4679
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHL008199207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1837330Medicaid
M38130001Medicare ID - Type Unspecified
MI1837330Medicaid