| Doctor Name: | MARK DAVID LINVILLE |
| NPI Number: | 1700222585 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 40313 |
| Business Practice Address: | 807 University Pkwy Johnson City, TN - 376146500 |
| Business Phone Number: | 4234398023 |
| Business Fax Number: | |
| Mailing Address: | 3329 Bondwood Cir, JOHNSON CITY |
| State: | TN |
| Postal Code: | 376048904 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/20/2013 |
| NPI Last Update Date: | 05/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 40313 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |