Provider Demographics
NPI:1861688707
Name:BARRUTIA FAMILY MEDICINE, PLC
Entity Type:Organization
Organization Name:BARRUTIA FAMILY MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAUSTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-439-0800
Mailing Address - Street 1:5750 W THUNDERBIRD RD
Mailing Address - Street 2:G-780
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4660
Mailing Address - Country:US
Mailing Address - Phone:602-439-0800
Mailing Address - Fax:602-439-8013
Practice Address - Street 1:5750 W THUNDERBIRD RD
Practice Address - Street 2:G-780
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4660
Practice Address - Country:US
Practice Address - Phone:602-439-0800
Practice Address - Fax:602-439-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z101166Medicare PIN