Organization
SMI IMAGING, LLC
Active
Organization
SMI IMAGING, LLC
Active
Other names
SimonMed Imaging - Prescott Valley
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD J SIMON M.D. (PRESIDENT)
(480) 264-2400
Entity
Organization
Contact information
Practice address
3033 N WINDSONG DR, SUITE 102, PRESCOTT VALLEY, AZ 86314-2290
(928) 772-5250
(928) 775-5728
Mailing address
PO BOX 7368, ORANGE, CA 92863-7368
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OTC4919
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
566316
—
AZ
Enumeration date
02/19/2010
Last updated
03/30/2011
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