| Organization Name: | JOHN C LINCOLN LLC |
| NPI Number: | 1073609848 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NATHAN ANSPACH (SR. VICE PRESIDENT) |
| Mailing Address: | 3648 W Anthem Way Suite A100 Anthem |
| State: | AZ US |
| Postal Code: | 85086 |
| Phone Number: | 6024857482 |
| Fax Number: | 6234346448 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 03/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | OTC3148 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |