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General NPI Number Information
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NPI Number | 1477887982
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Entity Type | Organization
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Legal Business Name | AZ-TECH RADIOLOGY & OPEN MRI
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 444 W OSBORN RD SUITE 105
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City | PHOENIX
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State | AZ
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Zip | 85013-3814
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Country | US
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Telephone | 602-277-4111
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Fax | 480-515-1353
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Provider Business Mailing Address
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Address Line | 2653 W GUADALUPE RD SUITE 201
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City | MESA
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State | AZ
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Zip | 85202-7200
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Country | US
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Telephone | 480-889-3500
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Fax | 480-889-3502
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Authorized Official
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Title or Position | VICE PRESIDENT FINANCE
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Name | SHARON B KORDAN
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Credential |
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Telephone | 480-889-1856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 174400000X
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License Number State | AZ
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