Provider Demographics
NPI:1679659205
Name:PRESCOTT OSTEOPOROSIS TESTING CENTER
Entity type:Organization
Organization Name:PRESCOTT OSTEOPOROSIS TESTING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:928-445-2424
Mailing Address - Street 1:3633 CROSSINGS DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7101
Mailing Address - Country:US
Mailing Address - Phone:928-445-2424
Mailing Address - Fax:928-445-7712
Practice Address - Street 1:3633 CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:928-445-2424
Practice Address - Fax:928-445-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ25601Medicare ID - Type Unspecified