MEDICARE: RADIOLOGICAL SERVICES OF NORTHERN ARIZONA, PC

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1528003233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGICAL SERVICES OF NORTHERN ARIZONA, PC

Provider Business Mailing Address
First Line	:	1944 MESQUITE AVE
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5729
Country	:	US
Telephone Number	:	928-505-9729
Fax Number	:	928-505-9200

Provider Business Practice Location Address
First Line	:	1944 MESQUITE AVE
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5729
Country	:	US
Telephone Number	:	928-505-9729
Fax Number	:	928-505-9200

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AYMAN N AWAD
Credential	:	MD
Telephone Number	:	928-505-9729

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	03/02/2011

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