Provider Demographics
NPI:1861417271
Name:BARTZ, HEATHER M (DO)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:BARTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1111 E MCDOWELL RD
Mailing Address - Street 2:INTERNAL MEDICINE DEPARTMENT
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2612
Mailing Address - Country:US
Mailing Address - Phone:602-239-2296
Mailing Address - Fax:602-239-2084
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:INTERNAL MEDICINE DEPARTMENT
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-239-2296
Practice Address - Fax:602-239-2084
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4376208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113534Medicare PIN