Provider Demographics
NPI:1154395531
Name:HONAN, LORNA F (MD)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:F
Last Name:HONAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 12TH ST
Mailing Address - Street 2:STE 518
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2849
Mailing Address - Country:US
Mailing Address - Phone:602-257-9488
Mailing Address - Fax:602-254-4258
Practice Address - Street 1:1300 N 12TH ST
Practice Address - Street 2:STE 518
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2849
Practice Address - Country:US
Practice Address - Phone:602-257-9488
Practice Address - Fax:602-254-4258
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ298308Medicaid
AZ298308Medicaid
AZ105564Medicare ID - Type Unspecified
AZZ122299Medicare PIN