Organization
VILLAGE OF OAK CREEK MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY D ZARETZKY MD (OWNER)
(928) 284-3236
Entity
Organization
Contact information
Practice address
6486 HWY 179, STE 107, SEDONA, AZ 86351-7993
(928) 284-3236
(928) 284-2531
Mailing address
PO BOX 1936, COTTONWOOD, AZ 86326-1936
(928) 634-0665
(928) 634-0337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23452
AZ
207RG0100X
Gastroenterology Physician
Primary
23452
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357287
—
AZ
Enumeration date
03/19/2009
Last updated
05/19/2009
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