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Organization
JOHN C LINCOLN LLC
Active
Organization
JOHN C LINCOLN LLC
Active
Other names
Pinnacle Anthem
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN ANSPACH (SR. VP)
(623) 434-6200
Entity
Organization
Contact information
Practice address
3648 W ANTHEM WAY, SUITE A100, ANTHEM, AZ 85086
(602) 485-7482
(623) 434-6448
Mailing address
2500 W UTOPIA RD, SUITE 100, PHOENIX, AZ 85027-4171
(623) 434-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OTC 3490
AZ
261QR0200X
Radiology Clinic/Center
OTC3148
AZ
Other
Enumeration date
10/05/2006
Last updated
07/24/2017
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