Healthcare Provider Details
I. General information
NPI: 1376725895
Provider Name (Legal Business Name): BARBARA R KLUGER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/27/2007
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13825 N 7TH ST SUITE J
PHOENIX AZ
85022-4342
US
IV. Provider business mailing address
13825 N 7TH ST SUITE J
PHOENIX AZ
85022-4342
US
V. Phone/Fax
- Phone: 602-863-3668
- Fax: 602-863-6651
- Phone: 602-863-3668
- Fax: 602-863-6651
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BARBARA
REGINA
KLUGER
Title or Position: OWNER
Credential: DPM
Phone: 602-863-3668