Healthcare Provider Details

I. General information

NPI: 1447236500
Provider Name (Legal Business Name): MARION REGIONAL CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 CRESCENT HEIGHTS RD
MARION OH
43302-6406
US

IV. Provider business mailing address

PO BOX 182255
COLUMBUS OH
43218-2255
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-6722
  • Fax:
Mailing address:
  • Phone: 614-430-5712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MIKE WEIR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-387-7200