Provider Demographics
NPI:1104358845
Name:LINVILLE, NATHANIEL C (MD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:C
Last Name:LINVILLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NATHANIEL
Other - Middle Name:C
Other - Last Name:LINVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:130 OAKRIDGE ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25053-8033
Mailing Address - Country:US
Mailing Address - Phone:304-687-9597
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-5956
Practice Address - Fax:859-323-1080
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYIP1556207L00000X
390200000X
KY55315207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program