| Organization Name: | MGG IMAGING, LLC |
| NPI Number: | 1770633166 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL GERALD GILBERT (OWNER) |
| Mailing Address: | Highway 264 Mile Post 388 Polacca |
| State: | AZ US |
| Postal Code: | 86042 |
| Phone Number: | 9283736000 |
| Fax Number: | 5208580218 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 12/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |