Healthcare Provider Details

I. General information

NPI: 1760509657
Provider Name (Legal Business Name): BRIAN K LINN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W ERIE AVE
HARRISON AR
72601-3539
US

IV. Provider business mailing address

224 W ERIE AVE
HARRISON AR
72601-3539
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-8289
  • Fax: 870-741-0308
Mailing address:
  • Phone: 870-741-8289
  • Fax: 870-741-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE5068
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberE-5068
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: