MEDICARE: LINDA J TRUITT 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	207V00000X	Obstetrics & Gynecology Physician	17676	OK

General Provider Information

NPI Number	:	1598722142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA J TRUITT MD

Provider Business Mailing Address
First Line	:	3435 NW 56TH ST
Second Line	:	SUITE 404
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4448
Country	:	US
Telephone Number	:	405-946-4735
Fax Number	:	405-946-4874

Provider Business Practice Location Address
First Line	:	3435 NW 56TH ST
Second Line	:	SUITE 404
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4448
Country	:	US
Telephone Number	:	405-946-4735
Fax Number	:	405-946-4874

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	07/08/2007

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