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General NPI Number Information
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NPI Number | 1851505309
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Entity Type | Organization
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Legal Business Name | BILOXI RADIATION ONCOLOGY CENTER LLC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 1732 MEDICAL PARK DR
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City | BILOXI
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State | MS
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Zip | 39532-2131
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Country | US
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Telephone | 228-314-2510
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Fax | 228-314-2517
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Provider Business Mailing Address
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Address Line | 1732 MEDICAL PARK DR
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City | BILOXI
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State | MS
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Zip | 39532-2131
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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 | PRESIDENT
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Name | DR. WILLIAM BURLESON
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Credential | MD
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Telephone | 228-314-2510
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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 | 13432
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License Number State | MS
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