Basic Information
| Provider Information | |||||||||
| NPI: | 1316056229 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLINT | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 E MAHONEY ST | ||||||||
| Address2: | |||||||||
| City: | WINSLOW | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860472722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285870380 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2174 W OAK AVE | ||||||||
| Address2: | |||||||||
| City: | DOUGLAS | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856076003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203647931 | ||||||||
| FaxNumber: | 5203642551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 32-1434 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A60969 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 811283 | 05 | AZ | MEDICAID |