Organization
SIERRA VISTA DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN I. WALSH M.D. (MANAGING PARTNER)
(520) 459-5227
Entity
Organization
Contact information
Practice address
155 CALLE PORTAL STE 500, SIERRA VISTA, AZ 85635-2973
(520) 459-5227
(520) 459-2191
Mailing address
155 CALLE PORTAL STE 500, SIERRA VISTA, AZ 85635-2973
(520) 459-5227
(520) 459-2191
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
9110
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220575001
—
AZ
05
—
255085001
—
AZ
01
—
DD8752
RAILROAD MEDICARE
AZ
Enumeration date
10/12/2007
Last updated
12/19/2012
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