Healthcare Provider Details

I. General information

NPI: 1174721716
Provider Name (Legal Business Name): NORFOLK RADIAITON ONCOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 TAYLOR AVE
NORFOLK NE
68701-4511
US

IV. Provider business mailing address

PO BOX 1666
NORFOLK NE
68702-1666
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-5070
  • Fax: 402-371-5070
Mailing address:
  • Phone: 402-371-0925
  • Fax: 402-371-0925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHAMMED K ZAHRA
Title or Position: OWNER
Credential: MD
Phone: 402-371-0925