Provider Demographics
NPI:1174682710
Name:KENTUCKY RADIATION THERAPY ASSOCIATES PSC
Entity Type:Organization
Organization Name:KENTUCKY RADIATION THERAPY ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEITHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-706-5065
Mailing Address - Street 1:PO BOX 2353
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-2353
Mailing Address - Country:US
Mailing Address - Phone:270-706-5065
Mailing Address - Fax:270-706-1082
Practice Address - Street 1:913 N DIXIE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2503
Practice Address - Country:US
Practice Address - Phone:270-706-5065
Practice Address - Fax:270-706-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284462085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2437860000OtherPASSPORT
IN200316840AMedicaid
KY65921868Medicaid
IN200316840AMedicaid
KY65921868Medicaid