=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861689762
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEMATOLOGY ONCOLOGY CONSULTANTS, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2007
-----------------------------------------------------
Last Update Date | 09/25/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1628 N MAIN ST SUITE A
-----------------------------------------------------
City | RUSHVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46173-1121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-445-8575
-----------------------------------------------------
Fax | 317-577-1145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11313 USA PKWY SUITE 138
-----------------------------------------------------
City | FISHERS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46037-9208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-558-6026
-----------------------------------------------------
Fax | 317-558-6186
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ROBERT CLARENCE ASH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 317-445-8575
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 01041068A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------