Provider Demographics
NPI:1467126474
Name:THE LINBERG CLINIC PLLC
Entity Type:Organization
Organization Name:THE LINBERG CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:HIGHT
Authorized Official - Last Name:LINSCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-364-3646
Mailing Address - Street 1:13129 SE 202ND RD
Mailing Address - Street 2:
Mailing Address - City:TALIHINA
Mailing Address - State:OK
Mailing Address - Zip Code:74571-5978
Mailing Address - Country:US
Mailing Address - Phone:580-364-3646
Mailing Address - Fax:
Practice Address - Street 1:367 W CLIFF DR
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-1404
Practice Address - Country:US
Practice Address - Phone:580-364-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health