Individual
DR. C ROGER BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-3000
Mailing address
PO BOX 27340, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-3000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
16741
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
16741
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296500
—
AZ
01
—
AZ0382090
BCBSAZ
AZ
01
—
IZ7046
HEALTH NET OF AZ
AZ
01
—
XPY108340
MEDI-CAL MEDICAID
AZ
Enumeration date
02/24/2006
Last updated
09/24/2012
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