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General NPI Number Information
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NPI Number | 1083233043
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Entity Type | Individual
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Provider Name | ETHAN HIGHT LINSCOTT DO
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 367 W CLIFF DR
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City | ATOKA
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State | OK
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Zip | 74525-1404
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Country | US
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Telephone | 580-364-3646
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Fax | 580-297-7832
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Provider Business Mailing Address
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Address Line | PO BOX 1304
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City | ATOKA
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State | OK
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Zip | 74525-6304
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Country | US
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Telephone | 580-364-3646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7377
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License Number State | OK
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