A. Clark Ruttinger D O PLLC
Family Medicine, Geriatric Medicine in Surprise, AZ. Organization (NPI-2).
NPI number1174706519
StatusActive
Last updated in NPPESFeb 5, 2023
Details
- NPI
- 1174706519
- Entity type
- Organization (NPI-2)
- Legal business name
- A. Clark Ruttinger D O PLLC
- Organization subpart
- No
- Enumeration date
- Dec 7, 2007
- Certification date
- Feb 5, 2023
- Last updated
- Feb 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QG0300X | Family Medicine, Geriatric Medicine | 2607 | AZ | Yes |
Practice location
13951 W Grand Ave Ste 203Surprise, AZ 85374-2436
Phone 623-544-4600 · Fax 623-544-4725
Mailing address
13951 W Grand Ave Ste 203Surprise, AZ 85374-2436
Phone 623-544-4600 · Fax 623-544-4725
Authorized official
Albert Clark Ruttinger
Owner
6235444600
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