Provider Demographics
NPI:1811912827
Name:LYTLE, MICHAEL F (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:LYTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 13385
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-3385
Mailing Address - Country:US
Mailing Address - Phone:480-609-9300
Mailing Address - Fax:480-609-9350
Practice Address - Street 1:8970 E RAINTREE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7300
Practice Address - Country:US
Practice Address - Phone:480-609-9300
Practice Address - Fax:480-609-9350
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30364207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00188932Medicare PIN
C50705Medicare UPIN
AZZ84162Medicare PIN