Healthcare Provider Details

I. General information

NPI: 1851335715
Provider Name (Legal Business Name): ADRIENNE FORSTNER BARTHELL MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 W THUNDERBIRD RD STE 10
GLENDALE AZ
85306-4700
US

IV. Provider business mailing address

5422 W THUNDERBIRD RD STE 10
GLENDALE AZ
85306-4700
US

V. Phone/Fax

Practice location:
  • Phone: 602-993-2622
  • Fax: 602-993-2922
Mailing address:
  • Phone: 602-993-2622
  • Fax: 602-993-2922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ADRIENNE W FORSTNER-BARTHELL
Title or Position: MANAGER
Credential: MD
Phone: 602-993-2622