MEDICARE: REGIONAL CONSULTANTS IN HEMATOLOGY ONCOLOGY, INC.

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
1	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1447247762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL CONSULTANTS IN HEMATOLOGY ONCOLOGY, INC.

Provider Business Mailing Address
First Line	:	1235 SAN MARCO BLVD
Second Line	:	3RD FLOOR
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8554
Country	:	US
Telephone Number	:	904-493-5100
Fax Number	:	904-493-5130

Provider Business Practice Location Address
First Line	:	1235 SAN MARCO BLVD
Second Line	:	3RD FLOOR
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8554
Country	:	US
Telephone Number	:	904-493-5100
Fax Number	:	904-493-5130

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. RONALD W DOBSON JR.
Credential	:	JD
Telephone Number	:	904-493-5372

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	01/14/2008

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