Organization
BETHANY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A AYIYI SR. (CEO)
(602) 301-0214
Entity
Organization
Contact information
Practice address
5270 N 59TH AVE, SUITE 11, GLENDALE, AZ 85301-6762
(623) 847-9800
(623) 847-9898
Mailing address
5270 NORTH 59TH AVENUE SITE 11, GLENDALE, AZ 85301-6764
(623) 847-9800
(623) 934-5360
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/04/2007
Last updated
08/22/2020
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