Organization
ARIZONA INTERVENTIONAL MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J THEODORE KING (OWNER)
(630) 725-2768
Entity
Organization
Contact information
Practice address
2338 W ROYAL PALM RD, SUITE J, PHOENIX, AZ 85021-9339
(630) 725-2768
(877) 219-4810
Mailing address
1901 BUTTERFIELD RD, 220, DOWNERS GROVE, IL 60515-7915
(630) 725-2768
(877) 219-4810
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
42646
AZ
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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