Organization
MDIG OF PENNSYLVANIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY PRINCE (RCM OPERATIONS MANAGER)
(480) 999-1091
Entity
Organization
Contact information
Practice address
10835 N 25TH AVE STE 140, PHOENIX, AZ 85029
(602) 246-2584
(602) 246-2566
Mailing address
10835 N 25TH AVE STE 240, PHOENIX, AZ 85029-3458
(602) 246-2584
(602) 246-2566
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PROCESSING
—
PA
Enumeration date
08/20/2018
Last updated
10/30/2018
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