| Tristan K Lineberry, MD | |
|
215 E Main St, Providence, KY 42450-1261 | |
| (270) 667-7017 | |
| Not Available |
| Full Name | Tristan K Lineberry |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 46 Years |
| Location | 215 E Main St, Providence, Kentucky |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336245349 | NPI | - | NPPES |
| 21614 | Other | KY | LICENSE |
| 000000044292 | Other | BCBS PROVIDER NUMBER | |
| 64216146 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 21614 (Kentucky) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Regional Health Care Affiliates, Inc | 3173668274 | 27 |
| Entity Name | Regional Health Care Affiliates, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558692558 PECOS PAC ID: 3173668274 Enrollment ID: O20100824000119 |
| Mailing Address | Practice Location Address |
|---|---|
| Tristan K Lineberry, MD Po Box 37, Providence, KY 42450-0037 Ph: (270) 667-7017 | Tristan K Lineberry, MD 215 E Main St, Providence, KY 42450-1261 Ph: (270) 667-7017 |
Kenneth W Cloern, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 215 E Main St, Providence, KY 42450 Phone: 270-667-7017 Fax: 270-667-9065 | |
Kelly L Cole, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 121 E Main St, Providence, KY 42450 Phone: 270-667-2023 Fax: 270-667-7518 | |
Jami T Perry, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 E Main St, Providence, KY 42450 Phone: 270-667-7017 Fax: 270-667-9065 |