Provider Demographics
NPI:1396822920
Name:STEPHEN T. LINN MD LLC
Entity Type:Organization
Organization Name:STEPHEN T. LINN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-985-1093
Mailing Address - Street 1:3108 CLEARWATER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7170
Mailing Address - Country:US
Mailing Address - Phone:480-985-1093
Mailing Address - Fax:
Practice Address - Street 1:3108 CLEARWATER DR
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7170
Practice Address - Country:US
Practice Address - Phone:480-985-1093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ104742Medicare PIN