Provider Demographics
NPI:1366559957
Name:LINVILLE, CORTNEY (DO)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:LINVILLE
Suffix:
Gender:F
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 351
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-0351
Mailing Address - Country:US
Mailing Address - Phone:207-882-6008
Mailing Address - Fax:207-882-7803
Practice Address - Street 1:35 WATER STR
Practice Address - Street 2:
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578
Practice Address - Country:US
Practice Address - Phone:207-882-6008
Practice Address - Fax:207-882-7803
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1366559957Medicaid
MEME154301Medicare PIN
MEMM6528Medicare PIN
ME130430000Medicaid