Healthcare Provider Details

I. General information

NPI: 1407823610
Provider Name (Legal Business Name): SCOTTSDALE MEDICAL IMAGING, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N SCOTTSDALE RD #130
SCOTTSDALE AZ
85251-5648
US

IV. Provider business mailing address

9700 N 91ST ST STE C200 SCOTTSDALE MEDICAL IMAGING, LTD.
SCOTTSDALE AZ
85258-5064
US

V. Phone/Fax

Practice location:
  • Phone: 480-425-5000
  • Fax: 480-425-5010
Mailing address:
  • Phone: 480-425-5000
  • Fax: 480-425-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RODNEY S OWEN
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 480-425-5000