Phoenix Radiology, Pllc

LBN: Phoenix Radiology, Pllc
Phoenix Radiology, Pllc is an health care organization with primary practice located at 415 6Th St , Lewiston ID 83501-2431. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty. Phoenix Radiology, Pllc can be contacted via phone (208) 799-5335, or through Peterson, Mark W via phone (208) 743-4393.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 799-5335
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Peterson, Mark W Doctor of Medicine (MD)
Phone: (208) 743-4393

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X

Profile Details

NPI number 1164493334
LBN Legal business name Phoenix Radiology, Pllc
DBA Doing business as
Authorized official Peterson, Mark W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 27th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164493334 NPPES
Other DC3860 RAILROAD MEDICARE
Other 0192979 RAILROAD MEDICARE
Other 000010148406 RAILROAD MEDICARE
Other 8J679 RAILROAD MEDICARE
MEDICAID 7124605 RAILROAD MEDICARE

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