Healthcare Provider Details
I. General information
NPI: 1104312701
Provider Name (Legal Business Name): AMERICAN ONCOLOGY PARTNERS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2018
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 MEDICAL CIR
NASHVILLE AR
71852
US
IV. Provider business mailing address
PO BOX 749495
ATLANTA GA
30374-9495
US
V. Phone/Fax
- Phone: 501-624-7700
- Fax:
- Phone: 239-432-8331
- Fax: 813-321-1296
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VIPUL
PATEL
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 855-963-2100