Provider Demographics
NPI:1326362286
Name:LINDA N TEAL, MD, PA
Entity type:Organization
Organization Name:LINDA N TEAL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:TEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-425-7788
Mailing Address - Street 1:444 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2900
Mailing Address - Country:US
Mailing Address - Phone:870-425-7788
Mailing Address - Fax:870-424-7457
Practice Address - Street 1:444 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2900
Practice Address - Country:US
Practice Address - Phone:870-425-7788
Practice Address - Fax:870-424-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6474207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR110466001Medicaid
ARA98938Medicare UPIN
AR5G484Medicare PIN