Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 9952 | AZ |
NPI | 1194725267 |
---|---|
Provider Name | Dr. Lawrence J Lincoln |
First Address | Tucson, AZ 85712-2211 |
Second Address | Tucson, AZ 85712-2211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 09/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
221482 | (05) | AZ |
AZ0015260 | BLUE CROSS/BLUE SHIELD (01) | AZ |
E38365 | (02) | AZ |