A. Clark Ruttinger D O Pllc | |
13951 W Grand Ave Ste 203 Surprise AZ 85374-2436 | |
(623) 544-4600 | |
(623) 544-4725 |
Full Name | A. Clark Ruttinger D O Pllc |
---|---|
Speciality | Family Medicine |
Location | 13951 W Grand Ave Ste 203, Surprise, Arizona |
Authorized Official Name and Position | Albert Clark Ruttinger (OWNER) |
Authorized Official Contact | 6235444600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
A. Clark Ruttinger D O Pllc 13951 W Grand Ave Ste 203 Surprise AZ 85374-2436 Ph: (623) 544-4600 | A. Clark Ruttinger D O Pllc 13951 W Grand Ave Ste 203 Surprise AZ 85374-2436 Ph: (623) 544-4600 |
NPI Number | 1174706519 |
---|---|
Provider Enumeration Date | 12/07/2007 |
Last Update Date | 02/05/2023 |
Medicare PECOS PAC ID | 6507941614 |
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Medicare Enrollment ID | O20080313000588 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174706519 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | 2607 (Arizona) | Primary |
Provider Name | Albert C Ruttinger |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740253434 PECOS PAC ID: 4880688191 Enrollment ID: I20040415000079 |
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