Healthcare Provider Details

I. General information

NPI: 1861688707
Provider Name (Legal Business Name): BARRUTIA FAMILY MEDICINE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 09/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 W THUNDERBIRD RD G-780
GLENDALE AZ
85306-4660
US

IV. Provider business mailing address

5750 W THUNDERBIRD RD G-780
GLENDALE AZ
85306-4660
US

V. Phone/Fax

Practice location:
  • Phone: 602-439-0800
  • Fax: 602-439-8013
Mailing address:
  • Phone: 602-439-0800
  • Fax: 602-439-8013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TONYA CLAUSTRE
Title or Position: OFFICE MANAGER
Credential:
Phone: 602-439-0800