Provider Demographics
NPI:1477196343
Name:RADIATION ONCOLOGY PROFESSIONAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY PROFESSIONAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-475-6532
Mailing Address - Street 1:5150 S 375 E STE 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TERRACE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4503
Mailing Address - Country:US
Mailing Address - Phone:801-475-6532
Mailing Address - Fax:801-475-6182
Practice Address - Street 1:1301 BERTHA HOWE AVE STE 10
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7503
Practice Address - Country:US
Practice Address - Phone:435-767-9104
Practice Address - Fax:435-652-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty