Organization
SOUTHEAST X-RAY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCOTT THORNOCK (CHIEF STRATEGY OFFICER)
(480) 369-1270
Entity
Organization
Contact information
Practice address
22601 N 19TH AVE STE 108, PHOENIX, AZ 85027-1324
(480) 369-1270
Mailing address
22601 N 19TH AVE STE 108, PHOENIX, AZ 85027-1324
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2009
Last updated
04/23/2026
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