Healthcare Provider Details

I. General information

NPI: 1740439595
Provider Name (Legal Business Name): RATKO JOHN SARAZIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E GUADALUPE RD STE 103
GILBERT AZ
85234-5116
US

IV. Provider business mailing address

16430 N SCOTTSDALE RD STE 210
SCOTTSDALE AZ
85254-1581
US

V. Phone/Fax

Practice location:
  • Phone: 480-907-6818
  • Fax: 480-907-5181
Mailing address:
  • Phone: 602-464-9576
  • Fax: 602-626-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME100050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: