Healthcare Provider Details

I. General information

NPI: 1295747277
Provider Name (Legal Business Name): BECKLEY ONCOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 DRY HILL RD BECKLEY ONCOLOGY ASSOCIATES INC
BECKLEY WV
25801
US

IV. Provider business mailing address

275 DRY HILL RD
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-253-6060
  • Fax: 304-929-2248
Mailing address:
  • Phone: 304-253-6060
  • Fax: 304-929-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL S LARSON
Title or Position: PRESIDENT
Credential: MD
Phone: 304-253-6060