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General NPI Number Information
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NPI Number | 1770616658
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Entity Type | Organization
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Legal Business Name | REGIONAL RADIATION ONCOLOGY CARE, PC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 830 PINE ST
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City | SIDNEY
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State | NE
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Zip | 69162-2284
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Country | US
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Telephone | 308-630-1716
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Fax | 308-630-1445
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Provider Business Mailing Address
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Address Line | PO BOX 2116
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City | SCOTTSBLUFF
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State | NE
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Zip | 69363-2116
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Country | US
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Telephone | 308-630-1716
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Fax | 308-630-1445
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ALLAN HARTMAN
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Credential | M.D.
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Telephone | 308-630-1716
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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 | 19219
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License Number State | NE
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