Healthcare Provider Details

I. General information

NPI: 1164460077
Provider Name (Legal Business Name): SIMONMED IMAGING, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 EAST MOUNTAIN VIEW ROAD SUITE 112
SCOTTSDALE AZ
85258-5140
US

IV. Provider business mailing address

6900 EAST CAMELBACK ROAD SUITE 700
SCOTTSDALE AZ
85251
US

V. Phone/Fax

Practice location:
  • Phone: 602-714-6160
  • Fax: 602-714-6161
Mailing address:
  • Phone: 480-809-4829
  • Fax: 623-322-6147

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. HOWARD J SIMON
Title or Position: OWNER
Credential: M.D.
Phone: 480-809-4829