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Individual

MARK D LINEBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1532 LONE OAK RD, SUITE 415, PADUCAH, KY 42003-7913
(270) 442-0103
(270) 442-0109
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(513) 981-5130
(513) 981-5015

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
22917
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
028189499
DEPT OF LABOR
01
060010637
RAILROAD MEDICARE
05
64229172
KY
Enumeration date
08/16/2006
Last updated
04/13/2015
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