Broughton, Bernetta E

Broughton, Bernetta E is an sole proprietor health care provider with primary practice located at 4700 N 51St Ave Ste 4, Phoenix AZ 85031-1237. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Broughton, Bernetta E can be contacted via phone (623) 846-7575.

Contact Information

Primary practice address
4700 N 51St Ave Ste 4 Phoenix AZ 85031-1237
Phone: (623) 846-7575
Fax: (623) 247-6386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 15087 Arizona
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 15087 Arizona

Profile Details

NPI number 1235134859
LBN Legal business name Broughton, Bernetta E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235134859 NPPES
Arizona Other AZ0182590 BCBS
Arizona Other 1Z8746 BCBS
Arizona MEDICAID 251794 BCBS
Arizona Other 770934 BCBS
Arizona Other 85031A006 BCBS

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