Healthcare Provider Details

I. General information

NPI: 1417288135
Provider Name (Legal Business Name): IMAGEWEST DIAGNOSTICS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 E HIGHLAND AVE SUITE, 120
PHOENIX AZ
85016-4872
US

IV. Provider business mailing address

PO BOX 27340
PHOENIX AZ
85061-7340
US

V. Phone/Fax

Practice location:
  • Phone: 602-977-1177
  • Fax: 602-977-2410
Mailing address:
  • Phone: 602-943-9200
  • Fax: 602-216-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN N. HOFFMAN
Title or Position: PRESIDENT
Credential:
Phone: 602-977-2408