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NPI Code Detail

MEDICARE: LOUIS DAVID LINSENBARDT DO

MEDICARE: LOUIS DAVID LINSENBARDT DO
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
1207Q00000XFamily Medicine Physician30321MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110178OTHERMOBCBS
2116585OTHERMOHEALTHLINK

General Provider Information

NPI Number : 1629175716
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIS DAVID LINSENBARDT DO
Provider Business Mailing Address
First Line : 2077 HONEYSUCKLE
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109
Country : US
Telephone Number : 573-636-3727
Fax Number :
Provider Business Practice Location Address
First Line : 3559 AMAZONAS
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109
Country : US
Telephone Number : 573-893-7848
Fax Number : 573-893-1984
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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