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NPI Code Detail

MEDICARE: HEMATOLOGY & ONCOLOGY CENTER, PLLC

MEDICARE: HEMATOLOGY & ONCOLOGY CENTER, PLLC
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
1207RH0003XHematology & Oncology Physician

General Provider Information

NPI Number : 1245289859
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEMATOLOGY & ONCOLOGY CENTER, PLLC
Provider Business Mailing Address
First Line : 401 BOGLE ST
Second Line : SUITE 101
City : SOMERSET
State : KY
Zip : 42503-2849
Country : US
Telephone Number : 606-676-0275
Fax Number : 606-676-0295
Provider Business Practice Location Address
First Line : 401 BOGLE ST
Second Line : SUITE 101
City : SOMERSET
State : KY
Zip : 42503-2849
Country : US
Telephone Number : 606-676-0275
Fax Number : 606-676-0295
Authorized Official
Title or Position : ORGANIZING MEMBER
Name : N MULLAI
Credential :
Telephone Number : 606-676-0275
Provider Enumeration Date : 05/09/2006
Last Update Date : 03/28/2014

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