Individual
TARA LINVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6565 S YALE AVE STE 1200, TULSA, OK 74136
(918) 502-3376
(918) 502-3375
Mailing address
6600 S YALE AVE STE 1200, TULSA, OK 74136-3361
(918) 488-6045
(918) 488-6098
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1108
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060190A
—
OK
Enumeration date
12/28/2005
Last updated
05/14/2018
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