Provider Demographics
NPI:1205091717
Name:SPICKARD, LINDA PALMETTA
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:PALMETTA
Last Name:SPICKARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E ALEXANDER CT
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5032
Mailing Address - Country:US
Mailing Address - Phone:304-723-0573
Mailing Address - Fax:304-723-0573
Practice Address - Street 1:1820 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1949
Practice Address - Country:US
Practice Address - Phone:740-537-9425
Practice Address - Fax:740-537-9837
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-22897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist