MEDICARE: XRAY PHYSICIANS, LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247100000X	Radiologic Technologist	2302	AZ
2	247100000X	Radiologic Technologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2302	OTHER	AZ	ARIZONA MEDICAL LICENSE
3	270231	OTHER	AZ	AHCCCS

General Provider Information

NPI Number	:	1215931092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XRAY PHYSICIANS, LTD.

Provider Business Mailing Address
First Line	:	2001 W. ORANGE GROVE RD.
Second Line	:	STE 104
City	:	TUCSON
State	:	AZ
Zip	:	85704-1140
Country	:	US
Telephone Number	:	520-575-0000
Fax Number	:	520-797-8160

Provider Business Practice Location Address
First Line	:	2001 W. ORANGE GROVE RD.
Second Line	:	#104
City	:	TUCSON
State	:	AZ
Zip	:	85704
Country	:	US
Telephone Number	:	520-575-0000
Fax Number	:	520-797-8160

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CANDACE COLLINS
Credential	:
Telephone Number	:	520-575-0000

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	11/19/2010

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Directions to “XRAY PHYSICIANS, LTD. ” Practice Location

Language	Start Address	Practice Location

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