MEDICARE: DR. LEANNA J SCOTT-TIMPERLEY MD

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	207RX0202X	Medical Oncology Physician	2003-0274	NM
2	207RH0003X	Hematology & Oncology Physician	2003-0274	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00018045	OTHER		RAILROAD MEDICARE PIN

General Provider Information

NPI Number	:	1588663306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEANNA J SCOTT-TIMPERLEY MD

Provider Business Mailing Address
First Line	:	490A W ZIA RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6996
Country	:	US
Telephone Number	:	505-913-8900
Fax Number	:	505-913-8923

Provider Business Practice Location Address
First Line	:	490A W ZIA RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6996
Country	:	US
Telephone Number	:	505-913-8900
Fax Number	:	505-913-8923

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/30/2013

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