Provider Demographics
NPI:1265451868
Name:MEDICAL ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:MEDICAL ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONCOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-669-4222
Mailing Address - Street 1:PO BOX 22097
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-2097
Mailing Address - Country:US
Mailing Address - Phone:517-669-4222
Mailing Address - Fax:517-669-4222
Practice Address - Street 1:2901 STABLER ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3022
Practice Address - Country:US
Practice Address - Phone:616-669-4222
Practice Address - Fax:616-669-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013923207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty