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General NPI Number Information
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NPI Number | 1386088573
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Entity Type | Organization
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Legal Business Name | SMI IMAGING, LLC
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 8630 E VIA DE VENTURA SUITE 208
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3326
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Country | US
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Telephone | 602-513-8750
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Fax | 602-513-8751
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Provider Business Mailing Address
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Address Line | PO BOX 53582
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City | PHOENIX
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State | AZ
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Zip | 85072-3582
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Country | US
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Telephone | 888-685-3907
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Fax | 800-508-4751
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HOWARD J SIMON
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Credential | M.D.
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Telephone | 480-478-6545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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