| Organization Name: | NEW IMAGE FAMILY MEDICINE LLC |
| NPI Number: | 1215012646 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILO A ROGERS (OWNER) |
| Mailing Address: | 13838 S 46th Pl Suite 120 Phoenix |
| State: | AZ US |
| Postal Code: | 850447800 |
| Phone Number: | 4807050480 |
| Fax Number: | 4807050481 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 11/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |