Healthcare Provider Details

I. General information

NPI: 1063438190
Provider Name (Legal Business Name): LYTLE ARIZONA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8970 E RAINTREE DR SUITE 100
SCOTTSDALE AZ
85260-7300
US

IV. Provider business mailing address

PO BOX 13385
SCOTTSDALE AZ
85267-3385
US

V. Phone/Fax

Practice location:
  • Phone: 480-609-9300
  • Fax: 480-609-9350
Mailing address:
  • Phone: 480-609-9300
  • Fax: 480-609-9350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL F LYTLE
Title or Position: OWNER
Credential: MD
Phone: 480-609-9300