Healthcare Provider Details
I. General information
NPI: 1205806601
Provider Name (Legal Business Name): NORALANE M LINDOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2006
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13400 E SHEA BLVD MAYO CLINIC
SCOTTSDALE AZ
85259-5452
US
IV. Provider business mailing address
13400 E SHEA BLVD MAYO CLINIC
SCOTTSDALE AZ
85259-5452
US
V. Phone/Fax
- Phone: 480-301-6817
- Fax:
- Phone: 480-301-6817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 19576 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207SG0201X |
| Taxonomy | Clinical Genetics (M.D.) Physician |
| License Number | 27910 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207SG0201X |
| Taxonomy | Clinical Genetics (M.D.) Physician |
| License Number | 19576 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: