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General NPI Number Information
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NPI Number | 1871557355
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Entity Type | Individual
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Provider Name | LINDA KAY YOUNGBERG DO
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Gender | Female
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 06/26/2013
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Provider Practice Location Address
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Address Line | 735 N FOREMAN ST
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City | VINITA
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State | OK
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Zip | 74301-1422
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Country | US
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Telephone | 918-256-7551
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Fax | 918-256-3703
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Provider Business Mailing Address
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Address Line | PO BOX 326
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City | VINITA
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State | OK
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Zip | 74301-0326
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Country | US
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Telephone | 918-256-7551
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Fax | 918-256-3703
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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 | 2410
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R5H41
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License Number State | MO
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