Provider Demographics
NPI:1528242880
Name:NORTH FAMILY MEDICINE LTD
Entity type:Organization
Organization Name:NORTH FAMILY MEDICINE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:SR
Authorized Official - Credentials:DO
Authorized Official - Phone:623-937-3373
Mailing Address - Street 1:7802 N 43RD AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-8111
Mailing Address - Country:US
Mailing Address - Phone:623-937-3373
Mailing Address - Fax:
Practice Address - Street 1:7802 N 43RD AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-8111
Practice Address - Country:US
Practice Address - Phone:623-937-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ255027Medicaid
AZ255027Medicaid