Provider Demographics
NPI:1386088573
Name:SMI IMAGING, LLC
Entity type:Organization
Organization Name:SMI IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-478-6545
Mailing Address - Street 1:PO BOX 53582
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85072-3582
Mailing Address - Country:US
Mailing Address - Phone:888-685-3907
Mailing Address - Fax:800-508-4751
Practice Address - Street 1:8630 E VIA DE VENTURA
Practice Address - Street 2:SUITE 208
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3326
Practice Address - Country:US
Practice Address - Phone:602-513-8750
Practice Address - Fax:602-513-8751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty