MEDICARE: DR. LYNNE PATRICE NOON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WL0500X	Low Vision Rehabilitation Optometrist	560	AZ

General Provider Information

NPI Number	:	1053318907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNNE PATRICE NOON O.D.

Provider Business Mailing Address
First Line	:	6446 E TRAILRIDGE CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85215-0810
Country	:	US
Telephone Number	:
Fax Number	:	480-705-4600

Provider Business Practice Location Address
First Line	:	10001 W BELL RD
Second Line	:	SUITE 115
City	:	SUN CITY
State	:	AZ
Zip	:	85351-1282
Country	:	US
Telephone Number	:	623-583-2800
Fax Number	:	623-583-1556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/27/2022

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