Healthcare Provider Details
I. General information
NPI: 1124337407
Provider Name (Legal Business Name): INTEGRATED ONCOLOGY NETWORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2010
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7337 E 2ND ST
SCOTTSDALE AZ
85251-5603
US
IV. Provider business mailing address
8950 S 52ND ST SUITE 101
TEMPE AZ
85284-1046
US
V. Phone/Fax
- Phone: 480-882-6234
- Fax:
- Phone: 602-441-9520
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NICHOLAS
E
FLORES
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 602-441-9520