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General NPI Number Information
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NPI Number | 1801658364
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Entity Type | Organization
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Legal Business Name | CENTRAL KENTUCKY RADIATION ONCOLOGY GROUP
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 520 TECHWOOD DR N STE 200
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City | DANVILLE
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State | KY
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Zip | 40422-8500
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Country | US
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Telephone | 859-236-9819
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Fax |
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Provider Business Mailing Address
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Address Line | 41 RIDGE RD
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City | RUTHERFORD
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State | NJ
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Zip | 07070-2136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LISA NICOLE BARRERA
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Credential |
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Telephone | 209-914-8534
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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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