Organization
MEDICAL DIAGNOSTIC SERVICE
Active
Organization
MEDICAL DIAGNOSTIC SERVICE
Active
Other names
Nevada Physician Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MALISSA THATCHER (CREDENTIALING SPECIALIST)
(702) 932-8547
Entity
Organization
Contact information
Practice address
700 E WARM SPRINGS RD, 301, LAS VEGAS, NV 89119-4305
(702) 318-2484
(702) 932-8587
Mailing address
2300 CORPORATE CIR, 190, HENDERSON, NV 89074-7724
(702) 318-2484
(702) 932-8587
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Enumeration date
05/11/2007
Last updated
09/17/2007
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