Provider Demographics
NPI:1922078492
Name:FOCUSED IMAGING OF ARIZONA INC
Entity Type:Organization
Organization Name:FOCUSED IMAGING OF ARIZONA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-246-2584
Mailing Address - Street 1:PO BOX 27340
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85061-7340
Mailing Address - Country:US
Mailing Address - Phone:602-943-9200
Mailing Address - Fax:602-216-3000
Practice Address - Street 1:2270 S RIDGEVIEW DR
Practice Address - Street 2:SUITE 127
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8875
Practice Address - Country:US
Practice Address - Phone:928-317-0470
Practice Address - Fax:928-317-0467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ637043Medicaid
AZP00237012Medicare PIN
AZZ111681Medicare PIN