Healthcare Provider Details

I. General information

NPI: 1962432427
Provider Name (Legal Business Name): CYNTHIA DARLENE BARRY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
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

Practice location:
  • Phone: 480-963-6144
  • Fax: 480-899-1404
Mailing address:
  • Phone: 480-963-6144
  • Fax: 480-899-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number2752
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: