Healthcare Provider Details
I. General information
NPI: 1629182746
Provider Name (Legal Business Name): ACCREDITED FAMILY HEALTHCARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
725 W ELLIOT RD BLDG. 3; SUITE 105
GILBERT AZ
85233-5301
US
IV. Provider business mailing address
725 W ELLIOT RD BLDG. 3; SUITE 105
GILBERT AZ
85233-5301
US
V. Phone/Fax
- Phone: 480-963-6144
- Fax: 480-899-1404
- Phone: 480-963-6144
- Fax: 480-899-1404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | 2752 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
CYNTHIA
DARLENE
BARRY
Title or Position: OWNER/PHYSICIAN
Credential: D.O.
Phone: 480-963-6144