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General NPI Number Information
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NPI Number | 1013315076
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Entity Type | Organization
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Legal Business Name | CLERMONT COUNTY CANCER CENTER LLC
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 4402 HARTMAN LN
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City | BATAVIA
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State | OH
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Zip | 45103-1971
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Country | US
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Telephone | 513-735-4442
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Fax | 513-735-4443
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Provider Business Mailing Address
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Address Line | 4402 HARTMAN LN
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City | BATAVIA
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State | OH
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Zip | 45103-1971
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Country | US
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Telephone | 513-735-4442
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Fax | 513-735-4443
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Authorized Official
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Title or Position | CEO
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Name | MS. PAYAL PATEL
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Credential |
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Telephone | 513-735-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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