Healthcare Provider Details

I. General information

NPI: 1982778239
Provider Name (Legal Business Name): REGIONAL ONCOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 5TH AVE
COLUMBUS GA
31904-8915
US

IV. Provider business mailing address

PO BOX 590
COLUMBUS GA
31902-0590
US

V. Phone/Fax

Practice location:
  • Phone: 706-320-8720
  • Fax:
Mailing address:
  • Phone: 706-320-8720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateGA

VIII. Authorized Official

Name: JANET BOHREN
Title or Position: GROUP PRACTICE MANAGER
Credential:
Phone: 706-320-8780