Healthcare Provider Details

I. General information

NPI: 1326251075
Provider Name (Legal Business Name): NORTH CAROLINA ONCOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 MACON POND ROAD
RALEIGH NC
27607-6319
US

IV. Provider business mailing address

4000 WESTCHASE BLVD SUITE 300
RALEIGH NC
27607-6863
US

V. Phone/Fax

Practice location:
  • Phone: 919-829-4450
  • Fax: 919-829-4486
Mailing address:
  • Phone: 919-829-4450
  • Fax: 919-829-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE RENE FRANCIS
Title or Position: STATE BUSINESS OFFICE ADMINISTRATOR
Credential:
Phone: 919-829-4450