# PRESCOTT INTERVENTIONAL RADIOLOGY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457314825
- **Authorized official:** DR. MOHAMED A KIRDANI M.D. (PRESIDENT OWNER)
- **Authorized official phone:** (928) 443-0077

## Contact information

- **Practice address:** 980 WILLOW CREEK RD, PRESCOTT, AZ 86301-1611
- **Practice address phone:** (928) 443-0077
- **Practice address fax:** (928) 443-0019
- **Mailing address:** PO BOX 27340, PHOENIX, AZ 85061-7340
- **Mailing address phone:** (602) 943-9200
- **Mailing address fax:** (602) 216-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2006
- **Last updated:** 09/11/2025