Healthcare Provider Details
I. General information
NPI: 1003938853
Provider Name (Legal Business Name): RADIATION ONCOLOGY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2007
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 MT. CARMEL WAY
PITTSBURG KS
66762
US
IV. Provider business mailing address
PO BOX 2787
JOPLIN MO
64803-2787
US
V. Phone/Fax
- Phone: 620-235-7900
- Fax: 620-235-7908
- Phone: 620-231-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | R4J03 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DUANE
E
MYERS
Title or Position: MD
Credential: MD
Phone: 620-235-7900