Basic Information
Provider Information
NPI: 1942498878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGEE
FirstName: BRIAN
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2929 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850168034
CountryCode: US
TelephoneNumber: 6024705000
FaxNumber: 6024705064
Practice Location
Address1: 2601 E ROOSEVELT ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850084973
CountryCode: US
TelephoneNumber: 6023445011
FaxNumber: 6023441004
Other Information
ProviderEnumerationDate: 10/04/2007
LastUpdateDate: 07/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X007808AZY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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