MEDICARE: MARK T LIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	2008024820	MO
2	207RG0100X	Gastroenterology Physician	42987	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366594749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK T LIN MD

Provider Business Mailing Address
First Line	:	5301 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2805
Country	:	US
Telephone Number	:	520-324-2684
Fax Number	:

Provider Business Practice Location Address
First Line	:	1396 N WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5132
Country	:	US
Telephone Number	:	520-420-2250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/19/2025

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Directions to “ MARK T LIN MD” Practice Location

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