Provider Demographics
NPI:1447588959
Name:SITUS ONCOLOGY
Entity Type:Organization
Organization Name:SITUS ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JIMM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:479-636-0500
Mailing Address - Street 1:504 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3432
Mailing Address - Country:US
Mailing Address - Phone:479-636-0500
Mailing Address - Fax:479-636-6161
Practice Address - Street 1:504 N 13TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3432
Practice Address - Country:US
Practice Address - Phone:479-636-0500
Practice Address - Fax:479-636-6161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SITUS CANCER RESEARCH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology