Provider Demographics
NPI:1053638528
Name:MONROEVILLE RADIATION ONCOLOGY
Entity Type:Organization
Organization Name:MONROEVILLE RADIATION ONCOLOGY
Other - Org Name:JACKSON MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:HIXSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-626-1755
Mailing Address - Street 1:3330 PRESTON RIDGE RD
Mailing Address - Street 2:300
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4508
Mailing Address - Country:US
Mailing Address - Phone:770-255-7430
Mailing Address - Fax:770-512-8937
Practice Address - Street 1:220 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:AL
Practice Address - Zip Code:36545-2459
Practice Address - Country:US
Practice Address - Phone:251-246-1159
Practice Address - Fax:770-512-8937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty