Organization
SAGUARC PEDIATRICS PLLC
Active
Other names
Judith Barnes-Clark, LLC DBA Building Blocks Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE MICHAEL ST. JACQUES MD (OWNER)
(480) 783-8960
Entity
Organization
Contact information
Practice address
4530 E. RAY RD, STE 130, PHOENIX, AZ 85044
(480) 783-8960
(780) 783-8967
Mailing address
4530 E. RAY RD, STE 130, PHOENIX, AZ 85044
(480) 783-8960
(780) 783-8967
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24143
AZ
208000000X
Pediatrics Physician
32674
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
424052
AHCCCS
AZ
Enumeration date
12/30/2009
Last updated
12/30/2009
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