Provider Demographics
NPI:1548591548
Name:SOUTHWEST MRI LLC
Entity Type:Organization
Organization Name:SOUTHWEST MRI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UCHENDU
Authorized Official - Middle Name:
Authorized Official - Last Name:AZODO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-707-9414
Mailing Address - Street 1:PO BOX 29211
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9211
Mailing Address - Country:US
Mailing Address - Phone:602-273-6770
Mailing Address - Fax:602-889-0483
Practice Address - Street 1:11013 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5243
Practice Address - Country:US
Practice Address - Phone:602-273-6770
Practice Address - Fax:602-889-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ418472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty