| 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 |
| Certification Date | 02/05/2023 |
| Medicare PECOS PAC ID | 6507941614 |
|---|---|
| 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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