Healthcare Provider Details

I. General information

NPI: 1477898583
Provider Name (Legal Business Name): PARADIGM DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 N 5TH ST 300
PHOENIX AZ
85004-2157
US

IV. Provider business mailing address

445 N 5TH ST 300
PHOENIX AZ
85004-2157
US

V. Phone/Fax

Practice location:
  • Phone: 605-569-2997
  • Fax:
Mailing address:
  • Phone: 602-850-7006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number32236
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN T CONROY
Title or Position: CFO
Credential:
Phone: 608-284-5700