Provider Demographics
NPI:1710120951
Name:DESERT RADIOLOGY LLC
Entity Type:Organization
Organization Name:DESERT RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINEY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:520-498-4899
Mailing Address - Street 1:10425 N ORACLE RD
Mailing Address - Street 2:STE 155
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9357
Mailing Address - Country:US
Mailing Address - Phone:520-498-4899
Mailing Address - Fax:520-575-7122
Practice Address - Street 1:10425 N ORACLE RD
Practice Address - Street 2:STE 155
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85737-9357
Practice Address - Country:US
Practice Address - Phone:520-498-4899
Practice Address - Fax:520-575-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC4468261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology