Provider Demographics
NPI:1922116409
Name:RADIOLOGY CONSULTANTS PLLC
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:480-940-9729
Mailing Address - Street 1:PO BOX 98341
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-0341
Mailing Address - Country:US
Mailing Address - Phone:480-940-9729
Mailing Address - Fax:480-940-9730
Practice Address - Street 1:15215 S 48TH ST
Practice Address - Street 2:BLDG 1, STE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-9142
Practice Address - Country:US
Practice Address - Phone:480-940-9729
Practice Address - Fax:480-940-9730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ195712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ841553Medicaid
AZZ78330Medicare PIN