Healthcare Provider Details

I. General information

NPI: 1699961300
Provider Name (Legal Business Name): ALLIANCE ONCOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 E KARSCH BLVD
FARMINGTON MO
63640-3408
US

IV. Provider business mailing address

505 W LOUISE AVE PO BOX 2649
MUSCLE SHOALS AL
35661-1517
US

V. Phone/Fax

Practice location:
  • Phone: 573-756-6797
  • Fax: 573-756-6147
Mailing address:
  • Phone: 256-383-3325
  • Fax: 256-383-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C WEEKS
Title or Position: C.F.O.
Credential:
Phone: 256-383-3325