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General NPI Number Information
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NPI Number | 1629248372
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Entity Type | Organization
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Legal Business Name | LAWRENCE RADIATION ONCOLOGY LLC
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 330 ARKANSAS SUITE 120
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City | LAWRENCE
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State | KS
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Zip | 66044-1485
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Country | US
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Telephone | 785-749-3600
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Fax | 785-749-3621
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Provider Business Mailing Address
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Address Line | 330 ARKANSAS SUITE 120
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City | LAWRENCE
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State | KS
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Zip | 66044-1335
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Country | US
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Telephone | 785-749-3600
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Fax | 785-749-3621
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Authorized Official
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Title or Position | BUSINESS OWNER/ MD
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Name | DR. DARREN KLISH
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Credential | MD
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Telephone | 785-749-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0431633
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License Number State | KS
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