Provider Demographics
NPI:1235196692
Name:ANALYTIC MEDICAL IMAGING, LTD
Entity Type:Organization
Organization Name:ANALYTIC MEDICAL IMAGING, LTD
Other - Org Name:ARIZONA MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-248-8002
Mailing Address - Street 1:11209 N TATUM BLVD
Mailing Address - Street 2:SUITE # 140
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3091
Mailing Address - Country:US
Mailing Address - Phone:602-248-8002
Mailing Address - Fax:602-248-8399
Practice Address - Street 1:11209 N TATUM BLVD
Practice Address - Street 2:SUITE # 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3091
Practice Address - Country:US
Practice Address - Phone:602-248-8002
Practice Address - Fax:602-248-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZWDBBFMedicare ID - Type Unspecified