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NPI Code Detail

MEDICARE: HEARTLAND ONCOLOGY, LLC

MEDICARE: HEARTLAND ONCOLOGY, LLC
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 : 1518388420
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND ONCOLOGY, LLC
Provider Business Mailing Address
First Line : 2337 E CRAWFORD ST
Second Line :
City : SALINA
State : KS
Zip : 67401-3713
Country : US
Telephone Number : 785-823-0633
Fax Number : 785-823-0658
Provider Business Practice Location Address
First Line : 204 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3563
Country : US
Telephone Number : 620-792-5511
Fax Number : 620-792-5977
Authorized Official
Title or Position : PARTNER
Name : LUIS ALFREDO LOPEZ
Credential :
Telephone Number : 785-823-0633
Provider Enumeration Date : 12/18/2013
Last Update Date : 12/18/2013

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Directions to “HEARTLAND ONCOLOGY, LLC ” Practice Location

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