MEDICARE: PERRY Y LIN MD PC

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	207V00000X	Obstetrics & Gynecology Physician	27274	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588681407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY Y LIN MD PC

Provider Business Mailing Address
First Line	:	77 W FOREST AVE
Second Line	:	203
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1483
Country	:	US
Telephone Number	:	928-213-6303
Fax Number	:	928-213-6304

Provider Business Practice Location Address
First Line	:	77 W FOREST AVE
Second Line	:	203
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1483
Country	:	US
Telephone Number	:	928-213-6303
Fax Number	:	928-213-6304

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PERRY LIN
Credential	:	M.D.
Telephone Number	:	928-213-6303

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	12/08/2008

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