Individual
JONATHON CHRISTOPHER RUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3552 W BASELINE RD STE 140, LAVEEN, AZ 85339-3042
(602) 635-6951
(602) 635-6952
Mailing address
3552 W BASELINE RD STE 140, LAVEEN, AZ 85339-3042
(602) 635-6951
(602) 635-6952
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8596
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8596
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANT
AZ
Enumeration date
09/07/2021
Last updated
01/22/2026
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