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NPI Code Detail

MEDICARE: WESTERN ARIZONA RADIOLOGY

MEDICARE: WESTERN ARIZONA RADIOLOGY
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 Physician24893AZ
22085R0202XDiagnostic Radiology Physician23353AZ

General Provider Information

NPI Number : 1699750786
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN ARIZONA RADIOLOGY
Provider Business Mailing Address
First Line : 6261 N LA CHOLLA BLVD
Second Line : #151
City : TUCSON
State : AZ
Zip : 85741-3565
Country : US
Telephone Number : 520-352-7600
Fax Number : 520-352-7610
Provider Business Practice Location Address
First Line : 6261 N LA CHOLLA BLVD
Second Line : #151
City : TUCSON
State : AZ
Zip : 85741-3565
Country : US
Telephone Number : 520-352-7600
Fax Number : 520-352-7610
Authorized Official
Title or Position : CO DIRECTOR
Name : ROBERT WAYNE ALLEN
Credential : MD
Telephone Number : 480-767-2222
Provider Enumeration Date : 12/12/2005
Last Update Date : 08/22/2020

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Directions to “WESTERN ARIZONA RADIOLOGY ” Practice Location

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