# JOHN C. LINCOLN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JOHN C. LINCOLN, LLC
- **Other names:** John C. Lincoln LifeStream at Thunderbird
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497005946
- **Legal business name:** JOHN C. LINCOLN, LLC
- **Authorized official:** NATHAN ANSPACH (SR. VICE PRESIDENT)
- **Authorized official phone:** (623) 434-6200

## Contact information

- **Practice address:** 13617 N 55TH AVE, GLENDALE, AZ 85304-4701
- **Practice address phone:** (602) 544-8541
- **Mailing address:** PO BOX 9907, PHOENIX, AZ 85068-0907
- **Mailing address phone:** (623) 434-6155
- **Mailing address fax:** (623) 434-6149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 09/12/2012