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NPI Code Detail

MEDICARE: UNIVERSITY RADIATION SPECIALTY, INC.

MEDICARE: UNIVERSITY RADIATION SPECIALTY, INC.
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
12085R0001XRadiation Oncology Physician

Other Identifiers

General Provider Information

NPI Number : 1578565123
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY RADIATION SPECIALTY, INC.
Provider Business Mailing Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1736
Country : US
Telephone Number : 216-844-7061
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1736
Country : US
Telephone Number : 216-844-7061
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. TIMOTHY KINSELLA
Credential : M.D.
Telephone Number : 216-844-7061
Provider Enumeration Date : 08/12/2005
Last Update Date : 08/22/2020

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Directions to “UNIVERSITY RADIATION SPECIALTY, INC. ” Practice Location

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