Opas & Puangtong Jutabha

Organization Active NPI Family Medicine Physician · Quartzsite, AZ

NPI 1508048273 · NPPES record last updated Apr 20, 2008

Key facts

NPI
1508048273
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
11855 (AZ)
Legal business name
OPAS & PUANGTONG JUTABHA
Practice address
394 N Central Blvd
Quartzsite, AZ 85346-1499
Phone
(928) 927-5454
Fax
(927) 928-3303
NPI assigned
Dec 4, 2007
Organization subpart
No

Authorized official

Name
Dr. Puangtong Jutabha, M.D.
Title
Owner
Phone
(928) 927-5454

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 11855 AZ Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X 11915 AZ

Addresses

Primary practice location

394 N Central Blvd
Quartzsite, AZ 85346-1499

Mailing address

PO Box 1499
Quartzsite, AZ 85346-1499
Phone (928) 927-5454

Other names

  • VALLEY MEDICAL CENTER Doing business as

Other providers in Quartzsite, AZ

All providers in Quartzsite, AZ · Family Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.