MEDICARE: MONTGOMERY RADIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0203X	Radiation Oncology Clinic/Center

General Provider Information

NPI Number	:	1073855300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY RADIATION

Provider Business Mailing Address
First Line	:	644 MAYSVILLE RD
Second Line	:
City	:	MOUNT STERLING
State	:	KY
Zip	:	40353-9464
Country	:	US
Telephone Number	:	740-566-4611
Fax Number	:

Provider Business Practice Location Address
First Line	:	644 MAYSVILLE RD
Second Line	:
City	:	MOUNT STERLING
State	:	KY
Zip	:	40353-9464
Country	:	US
Telephone Number	:	740-566-4611
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AARON WILLIAMS
Credential	:	MD
Telephone Number	:	740-566-4611

Provider Enumeration Date	:	03/25/2013
Last Update Date	:	03/25/2013

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Directions to “MONTGOMERY RADIATION ” Practice Location

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