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General NPI Number Information
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NPI Number | 1215107008
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Entity Type | Organization
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Legal Business Name | FORT SMITH RADIATION ONCOLOGY
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 8500 S 36TH TER
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City | FORT SMITH
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State | AR
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Zip | 72908-8880
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Country | US
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Telephone | 479-648-1800
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Fax | 479-434-5899
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Provider Business Mailing Address
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Address Line | PO BOX 5710
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City | FORT SMITH
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State | AR
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Zip | 72913-5710
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Country | US
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Telephone | 479-648-1800
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Fax | 479-434-5899
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | BECKY D FITZPATRICK
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Credential |
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Telephone | 479-648-1800
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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 | E1533
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License Number State | AR
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