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General NPI Number Information
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NPI Number | 1902896236
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Entity Type | Organization
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Legal Business Name | SOUTHWEST DIAGNOSTIC IMAGING LLC
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 3501 N SCOTTSDALE ROAD SUITE 130
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-8525
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Country | US
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Telephone | 480-425-5078
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Fax | 480-657-3470
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Provider Business Mailing Address
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Address Line | PO BOX 207762
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City | DALLAS
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State | TX
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Zip | 75320-7762
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Country | US
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Telephone | 480-425-5000
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Fax |
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Authorized Official
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Title or Position | CHIEF REVENUE CYCLE OFFICER
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Name | JENNIFER MOHLER
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Credential |
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Telephone | 480-425-4065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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