Healthcare Provider Details

I. General information

NPI: 1104772441
Provider Name (Legal Business Name): GEORGE FUSION IMAGING & CANCER THERANOSTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8894 SPANISH RIDGE AVE
LAS VEGAS NV
89148-1303
US

IV. Provider business mailing address

732 S 6TH ST STE N
LAS VEGAS NV
89101-6928
US

V. Phone/Fax

Practice location:
  • Phone: 215-917-8231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NOBLE GEORGE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 215-917-8231