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NPI Code Detail

MEDICARE: PHOENIX DIAGNOSTIC IMAGING INC

MEDICARE: PHOENIX DIAGNOSTIC IMAGING INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianAZ

General Provider Information

NPI Number : 1134104243
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHOENIX DIAGNOSTIC IMAGING INC
Provider Business Mailing Address
First Line : PO BOX 52527
Second Line :
City : PHOENIX
State : AZ
Zip : 85072-2527
Country : US
Telephone Number : 480-545-0113
Fax Number : 480-545-4267
Provider Business Practice Location Address
First Line : 10249 W THUNDERBIRD BLVD
Second Line : SUITE 200
City : SUN CITY
State : AZ
Zip : 85351-3113
Country : US
Telephone Number : 623-876-8800
Fax Number : 623-876-8881
Authorized Official
Title or Position : COO
Name : MR. DANIEL J SCHAEFER
Credential :
Telephone Number : 770-300-0101
Provider Enumeration Date : 12/12/2005
Last Update Date : 03/12/2009

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Directions to “PHOENIX DIAGNOSTIC IMAGING INC ” Practice Location

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