Provider Demographics
NPI:1609862903
Name:LINZMAN, ROD F (DO)
Entity Type:Individual
Prefix:
First Name:ROD
Middle Name:F
Last Name:LINZMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:HWY 81 & 70
Practice Address - Street 2:
Practice Address - City:WAURIKA
Practice Address - State:OK
Practice Address - Zip Code:73573
Practice Address - Country:US
Practice Address - Phone:580-228-3669
Practice Address - Fax:580-228-2529
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080083222OtherRAILROAD MEDICARE
OK56058065OtherAETNA
OK100089040AMedicaid
TX077807801Medicaid
OK100089040BMedicaid
OK56058065OtherAETNA