Organization
VIRGINIA RUTZ D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY-LOUISE MULCAHY RN, MBA, BSN (ADMINISTRATOR)
(480) 357-3904
Entity
Organization
Contact information
Practice address
100 TILBURY DR., KEARNY, AZ 85237
(520) 363-5573
(520) 363-5611
Mailing address
PO BOX 369, KEARNY, AZ 85237-0369
(520) 363-5573
(520) 363-5611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3090
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359168
—
AZ
Enumeration date
06/01/2005
Last updated
08/22/2020
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