Healthcare Provider Details
I. General information
NPI: 1003878232
Provider Name (Legal Business Name): KP ONCOLOGY LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2006
Last Update Date: 01/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18 SEIPLE DR
BLOOMSBURG PA
17815-7755
US
IV. Provider business mailing address
1201 GRAMPIAN BLVD STE 3A
WILLIAMSPORT PA
17701-1900
US
V. Phone/Fax
- Phone: 570-387-9020
- Fax: 570-387-9021
- Phone: 570-322-4025
- Fax: 570-322-6403
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
KARP
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 570-387-9020