Provider Demographics
NPI:1790058782
Name:ELLER, LINDA MARIE (DO)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:ELLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 E SHETLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1358
Mailing Address - Country:US
Mailing Address - Phone:520-370-6535
Mailing Address - Fax:
Practice Address - Street 1:9300 E RAINTREE DR STE 130
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7313
Practice Address - Country:US
Practice Address - Phone:480-300-6344
Practice Address - Fax:480-393-5147
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006379207Q00000X
VA0116024037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ924781Medicaid