Provider Demographics
NPI:1265473532
Name:LINN, DAVID KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KENNETH
Last Name:LINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1235 NE LOOP 286
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-2226
Mailing Address - Country:US
Mailing Address - Phone:903-785-4166
Mailing Address - Fax:903-785-4172
Practice Address - Street 1:1235 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-2226
Practice Address - Country:US
Practice Address - Phone:903-785-4166
Practice Address - Fax:903-785-4172
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9674207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101515801Medicaid
TXE08025Medicare UPIN
TX101515801Medicaid