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General NPI Number Information
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NPI Number | 1073844114
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Entity Type | Organization
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Legal Business Name | SANDHILLS ONCOLOGY PC
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 601 W LEOTA ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6525
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Country | US
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Telephone | 308-696-7741
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Fax |
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Provider Business Mailing Address
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Address Line | 601 W LEOTA ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6525
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Country | US
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Telephone | 308-696-7741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD E HLAVATY
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Credential | M.D.
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Telephone | 308-696-7741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 20065
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License Number State | NE
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