Organization
SOUTHWEST DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOHLER (CHIEF REVENUE CYCLE OFFICER)
(480) 425-4065
Entity
Organization
Contact information
Practice address
3501 N SCOTTSDALE ROAD, SUITE 130, SCOTTSDALE, AZ 85251-8525
(480) 425-5078
(480) 657-3470
Mailing address
PO BOX 207762, DALLAS, TX 75320-7762
(480) 425-5000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
858178
AHCCCS
AZ
Enumeration date
10/27/2005
Last updated
12/30/2024
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