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General NPI Number Information
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NPI Number | 1972876969
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Entity Type | Organization
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Legal Business Name | C. S. LIN MD
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Dates
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Enumeration Date | 02/21/2012
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 608 W LEE AVE
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City | OSCEOLA
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State | AR
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Zip | 72370-3002
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Country | US
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Telephone | 870-563-5096
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Fax | 870-563-8115
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Provider Business Mailing Address
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Address Line | 608 W LEE AVE
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City | OSCEOLA
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State | AR
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Zip | 72370-3002
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Country | US
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Telephone | 870-563-5096
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Fax | 870-563-8115
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHING-SHAN LIN
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Credential | MD
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Telephone | 870-563-5096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | R3435
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License Number State | AR
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