Provider Demographics
NPI:1649422536
Name:RADIOLOGISTS OF SIERRA VISTA PLLC
Entity Type:Organization
Organization Name:RADIOLOGISTS OF SIERRA VISTA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:OSUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-417-3104
Mailing Address - Street 1:PO BOX 4060
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2568
Mailing Address - Country:US
Mailing Address - Phone:928-634-0665
Mailing Address - Fax:928-634-0337
Practice Address - Street 1:300 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2812
Practice Address - Country:US
Practice Address - Phone:520-417-3104
Practice Address - Fax:520-417-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty