Healthcare Provider Details

I. General information

NPI: 1144498387
Provider Name (Legal Business Name): MEDICAL DIAGNOSTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 E PALMDALE ST SUITE 150
TUCSON AZ
85714-3309
US

IV. Provider business mailing address

1020 E PALMDALE ST SUITE 150
TUCSON AZ
85714-3309
US

V. Phone/Fax

Practice location:
  • Phone: 520-889-7777
  • Fax: 520-807-3777
Mailing address:
  • Phone: 520-889-7777
  • Fax: 520-807-3777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: HOVHANNES KARAGEZYAN
Title or Position: OWNER/ DIRECTOR
Credential:
Phone: 602-795-1555