Mansfield, Linda A
Mansfield, Linda A is an individual health care provider with primary practice located at 111 W Jefferson Blvd Ste 100 , South Bend IN 46601-1993. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Mansfield, Linda A can be contacted via phone (574) 647-1669.Contact Information
Primary practice address
111 W Jefferson Blvd Ste 100
South Bend IN 46601-1993
Phone: (574) 647-1669
Fax: (574) 239-6461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01069249A | Indiana |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 01069249A | Indiana |
Profile Details
| NPI number | 1629075957 |
|---|---|
| LBN Legal business name | Mansfield, Linda A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Apr 28th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629075957 | NPPES |
| Indiana | Other | 000000713021 | BCBS BMG SPORTS MEDICINE |
| Indiana | Other | P00955365 | BCBS BMG SPORTS MEDICINE |
| Indiana | MEDICAID | 201020040 | BCBS BMG SPORTS MEDICINE |
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