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General NPI Number Information
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NPI Number | 1396714515
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY GROUP CONSULTANTS, PC
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 2825 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8332
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Country | US
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Telephone | 541-772-0023
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8509
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City | MEDFORD
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State | OR
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Zip | 97501-5009
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Country | US
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Telephone | 541-772-0023
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERE SANDEFUR
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Credential | MD
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Telephone | 541-772-0023
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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 |
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License Number State |
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