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MODERN VASCULAR OF MESA LLC NPI 1427583087


NPI Information

NPI: 1427583087
Provider Name: MODERN VASCULAR OF MESA, LLC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

CLIA Number: 03D2132612

Address:
535 E MCKELLIPS RD STE 111
MESA, AZ
ZIP 85203
Phone: (480) 223-1333
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MODERN VASCULAR OF MESA, LLC is a vascular and interventional radiology radiology in Mesa, AZ. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. MODERN VASCULAR OF MESA, LLC NPI is 1427583087. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

535 E MCKELLIPS RD STE 111
MESA, AZ
ZIP 85203
Phone: (480) 223-1333

The provider's authorized official is Tim Murphy .
The authorized official title is Vp Operations and has the following contact phone number (818) 880-8605.

The CLIA number assigned to this NPI record is 03D2132612 - other - interventional proc cente with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/20/2017 and was last updated on 7/11/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3207RI0011XInternal MedicineInterventional CardiologyNo
4213E00000XPodiatristNo
52085R0204XRadiologyVascular & Interventional RadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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