Provider Demographics
NPI:1427428499
Name:BARRETT MEDICAL CONSULTNG, PA
Entity type:Organization
Organization Name:BARRETT MEDICAL CONSULTNG, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-478-0780
Mailing Address - Street 1:16601 N 40TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3345
Mailing Address - Country:US
Mailing Address - Phone:480-478-0780
Mailing Address - Fax:
Practice Address - Street 1:16601 N 40TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3345
Practice Address - Country:US
Practice Address - Phone:480-478-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0557213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty