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General NPI Number Information
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NPI Number | 1548508815
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Entity Type | Organization
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Legal Business Name | FRANKLIN RADIATION LLC
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 310 BIRCH ST
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City | CROWN POINT
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State | IN
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Zip | 46307-2607
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Country | US
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Telephone | 317-370-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 7002 WARWICK RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-1051
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Country | US
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Telephone | 317-370-8787
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAUL M DESROSIERS
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Credential | M.D.
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Telephone | 317-370-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | 01047188
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License Number State | IN
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