Provider Demographics
NPI:1063481950
Name:LINEWEAVER, SCOTT (BS)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:LINEWEAVER
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 W IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-8574
Mailing Address - Country:US
Mailing Address - Phone:480-899-6819
Mailing Address - Fax:480-855-1651
Practice Address - Street 1:2040 S ALMA SCHOOL RD STE 10
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7076
Practice Address - Country:US
Practice Address - Phone:888-439-3327
Practice Address - Fax:480-619-6243
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD4173237700000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0307340OtherBLUE CROSS BLUE SHIELD