Provider Demographics
NPI:1366583197
Name:JOHN R. LINSCOTT, M.D., INC.
Entity type:Organization
Organization Name:JOHN R. LINSCOTT, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:927-644-2070
Mailing Address - Street 1:225 STOCKSDALE DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5511
Mailing Address - Country:US
Mailing Address - Phone:937-644-2070
Mailing Address - Fax:937-644-0105
Practice Address - Street 1:225 STOCKSDALE DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-5511
Practice Address - Country:US
Practice Address - Phone:937-644-2070
Practice Address - Fax:937-644-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2011763Medicaid
OH2011763Medicaid