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General NPI Number Information
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NPI Number | 1275679920
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Entity Type | Organization
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Legal Business Name | PERMIAN RADIATION ONCOLOGY
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 GYPSY LANE
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City | YOUNGSTOWN
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State | OH
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Zip | 44501-0240
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Country | US
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Telephone | 330-884-4400
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Fax | 330-788-8871
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Provider Business Mailing Address
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Address Line | PO BOX 3776
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City | YOUNGSTOWN
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State | OH
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Zip | 44513-3776
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Country | US
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Telephone | 330-788-7137
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Fax | 330-788-8871
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC SVENSON
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Credential | MD
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Telephone | 330-788-7137
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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 | 35 05 3495
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License Number State | OH
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