Provider Demographics
NPI:1053633453
Name:INTEGRATED DIAGNOSTIC SOLUTIONS
Entity Type:Organization
Organization Name:INTEGRATED DIAGNOSTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMELINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-495-5644
Mailing Address - Street 1:6929 N HAYDEN RD
Mailing Address - Street 2:C4-220
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7978
Mailing Address - Country:US
Mailing Address - Phone:480-495-5644
Mailing Address - Fax:
Practice Address - Street 1:6929 N HAYDEN RD
Practice Address - Street 2:C4-220
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7978
Practice Address - Country:US
Practice Address - Phone:480-495-5644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty