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NPI Code Detail

MEDICARE: RADIATION ONCOLOGY PC

MEDICARE: RADIATION ONCOLOGY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician

General Provider Information

NPI Number : 1154374056
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIATION ONCOLOGY PC
Provider Business Mailing Address
First Line : 315 WALNUT ST
Second Line :
City : ATLANTIC
State : IA
Zip : 50022-1144
Country : US
Telephone Number : 712-243-7030
Fax Number : 712-243-7029
Provider Business Practice Location Address
First Line : 1001 PENNSYLVANIA AVE
Second Line :
City : OTTUMWA
State : IA
Zip : 52501-6427
Country : US
Telephone Number : 641-684-2480
Fax Number : 641-684-2479
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MS. LORI L STUART
Credential :
Telephone Number : 712-243-7030
Provider Enumeration Date : 05/19/2006
Last Update Date : 12/22/2009

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Directions to “RADIATION ONCOLOGY PC ” Practice Location

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