Healthcare Provider Details

I. General information

NPI: 1336546993
Provider Name (Legal Business Name): BENJAMIN M BARTON RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E SOUTHERN AVE STE 310
TEMPE AZ
85282-5691
US

IV. Provider business mailing address

1400 E SOUTHERN AVE STE 310
TEMPE AZ
85282-5691
US

V. Phone/Fax

Practice location:
  • Phone: 866-308-2700
  • Fax:
Mailing address:
  • Phone: 866-308-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRC2486
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: