Provider Demographics
NPI:1437273596
Name:THOMAS LINNEMANN DO PLLC
Entity Type:Organization
Organization Name:THOMAS LINNEMANN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:LINNEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-398-9604
Mailing Address - Street 1:PO BOX 43160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3160
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:2239 E FRONTAGE ROAD
Practice Address - Street 2:
Practice Address - City:TUBAC
Practice Address - State:AZ
Practice Address - Zip Code:85646
Practice Address - Country:US
Practice Address - Phone:520-398-9604
Practice Address - Fax:520-398-9689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3791261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherTIN