Provider Demographics
NPI:1902040264
Name:BURKE-SCOTT, LINDA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:BURKE-SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3941 E CHANDLER BLVD # 106-195
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0301
Mailing Address - Country:US
Mailing Address - Phone:480-759-8068
Mailing Address - Fax:
Practice Address - Street 1:320 E MCDOWELL RD STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4515
Practice Address - Country:US
Practice Address - Phone:602-523-7070
Practice Address - Fax:602-523-7071
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD19909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ126048Medicare PIN
AZE80460Medicare UPIN
AZZ132926Medicare UPIN