Healthcare Provider Details

I. General information

NPI: 1013015825
Provider Name (Legal Business Name): OSU RADIATION ONCOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8415
  • Fax: 614-293-4044
Mailing address:
  • Phone: 614-293-8415
  • Fax: 614-293-4044

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: JAMI HENSLEY
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 614-293-2229