Provider Demographics
NPI:1720289739
Name:RONAN, BRIDGETT A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIDGETT
Middle Name:A
Last Name:RONAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIDGETT
Other - Middle Name:A
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2368
Mailing Address - Country:US
Mailing Address - Phone:602-261-7830
Mailing Address - Fax:602-261-7835
Practice Address - Street 1:9700 N 91ST ST
Practice Address - Street 2:SUITE A200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5054
Practice Address - Country:US
Practice Address - Phone:480-614-2000
Practice Address - Fax:480-614-1751
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40596207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ525790Medicaid
AZ525790Medicaid