Provider Demographics
NPI:1033153994
Name:FORSTNER-BARTHELL, ADRIENNE W (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:W
Last Name:FORSTNER-BARTHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1303
Mailing Address - Country:US
Mailing Address - Phone:602-258-9900
Mailing Address - Fax:602-258-9904
Practice Address - Street 1:18275 N 59TH AVE STE 176
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-993-2622
Practice Address - Fax:602-993-2922
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29750208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ811506Medicaid
AZ811506Medicaid
H96871Medicare UPIN
AZZ115414Medicare PIN
AZZ118525Medicare PIN