Provider Demographics
NPI:1841308053
Name:BARRUTIA, TONYA M (MD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:M
Last Name:BARRUTIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8620 N 22ND AVE
Mailing Address - Street 2:200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4201
Mailing Address - Country:US
Mailing Address - Phone:602-674-6506
Mailing Address - Fax:602-674-6512
Practice Address - Street 1:5750 W THUNDERBIRD RD
Practice Address - Street 2:G780
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4682
Practice Address - Country:US
Practice Address - Phone:602-439-0800
Practice Address - Fax:602-439-0813
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2009-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ24397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ174766263463OtherHUMANA PROVIDER ID
AZ5850641OtherAETNA PROVIDER ID
AZ432211Medicaid
AZAZ0767580OtherBCBS PROVIDER ID
AZ174766263463OtherHUMANA PROVIDER ID
AZG76401Medicare UPIN
AZ5850641OtherAETNA PROVIDER ID
AZ101193Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID