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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 : 1871800086
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 : 1800 E VAN BUREN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-3742
Country : US
Telephone Number : 602-251-8100
Fax Number :
Authorized Official
Title or Position : AUTHORIZED SIGNER
Name : DR. TIMOTHY V MYERS
Credential : MD
Telephone Number : 208-292-2258
Provider Enumeration Date : 09/09/2010
Last Update Date : 11/10/2010

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