Provider Demographics
NPI:1780732412
Name:PIRIE, LYNNE (DO)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:PIRIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E CAREFREE HWY STE 208
Mailing Address - Street 2:NORTH PHOENIX HEALTH INSTITUTE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0109
Mailing Address - Country:US
Mailing Address - Phone:623-879-7580
Mailing Address - Fax:623-879-7510
Practice Address - Street 1:711 E CAREFREE HWY STE 208
Practice Address - Street 2:NORTH PHOENIX HEALTH INSTITUTE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0109
Practice Address - Country:US
Practice Address - Phone:623-879-7580
Practice Address - Fax:623-879-7510
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1878207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ253899Medicaid
AZZ0000BGMJPMedicare ID - Type Unspecified
AZ253899Medicaid