Healthcare Provider Details

I. General information

NPI: 1235196692
Provider Name (Legal Business Name): ANALYTIC MEDICAL IMAGING, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11209 N TATUM BLVD SUITE # 140
PHOENIX AZ
85028-3091
US

IV. Provider business mailing address

11209 N TATUM BLVD SUITE # 140
PHOENIX AZ
85028-3091
US

V. Phone/Fax

Practice location:
  • Phone: 602-248-8002
  • Fax: 602-248-8399
Mailing address:
  • Phone: 602-248-8002
  • Fax: 602-248-8399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR E. CLARK
Title or Position: PRESIDENT
Credential: MD
Phone: 602-248-8002