Healthcare Provider Details
I. General information
NPI: 1467405373
Provider Name (Legal Business Name): ARIZONA RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 03/29/2010
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
- Phone: 602-977-1177
- Fax: 602-977-2410
- Phone: 602-943-9200
- Fax: 602-216-3000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARLEE
HOFFMAN
Title or Position: OWNER PRESIDENT
Credential:
Phone: 602-977-1177