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NPI Code Detail

MEDICARE: NRS ARIZONA, PA

MEDICARE: NRS ARIZONA, PA
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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1295044790
Entity Type Code : Organization
Provider Name (Legal Business Name) : NRS ARIZONA, PA
Provider Business Mailing Address
First Line : 4900 N SCOTTSDALE RD
Second Line : SUITE 6000
City : SCOTTSDALE
State : AZ
Zip : 85251-7652
Country : US
Telephone Number : 208-292-2258
Fax Number :
Provider Business Practice Location Address
First Line : 1409 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7120
Country : US
Telephone Number : 702-649-7711
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : TIMOTHY V MYERS
Credential : MD
Telephone Number : 208-292-2258
Provider Enumeration Date : 09/30/2010
Last Update Date : 11/12/2010

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Directions to “NRS ARIZONA, PA ” Practice Location

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