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General NPI Number Information
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NPI Number | 1467126474
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Entity Type | Organization
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Legal Business Name | THE LINBERG CLINIC PLLC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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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 |
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Provider Business Mailing Address
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Address Line | 13129 SE 202ND RD
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City | TALIHINA
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State | OK
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Zip | 74571-5978
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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 | OWNER
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Name | DR. ETHAN HIGHT LINSCOTT
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Credential | DO
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Telephone | 580-364-3646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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