Provider Demographics
NPI:1851497952
Name:LINDA WROTEN P.C.
Entity Type:Organization
Organization Name:LINDA WROTEN P.C.
Other - Org Name:SOUTHWEST ADULT & GERIATRIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WROTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-314-3412
Mailing Address - Street 1:PO BOX 31432
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1432
Mailing Address - Country:US
Mailing Address - Phone:520-314-3412
Mailing Address - Fax:520-314-3413
Practice Address - Street 1:6890 E SUNRISE DR STE 120-176
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-0738
Practice Address - Country:US
Practice Address - Phone:520-314-3412
Practice Address - Fax:520-314-3413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP0046OtherBCBS
TX170652502Medicaid
TX170652503Medicaid
NP0046OtherBCBS
=========OtherTRICARE
TX170652501Medicaid
00985UMedicare PIN
00986UMedicare PIN
DF1620Medicare PIN
00987UMedicare PIN