Healthcare Provider Details
I. General information
NPI: 1851392211
Provider Name (Legal Business Name): CENTRAL OHIO RADIATION ONCOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 S GRANT AVE
COLUMBUS OH
43215-4701
US
IV. Provider business mailing address
PO BOX 951822
CLEVELAND OH
44193-0020
US
V. Phone/Fax
- Phone: 614-566-9506
- Fax: 614-566-8224
- Phone: 800-669-1518
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
CHUCK
C
CHO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 614-566-9506