Provider Demographics
NPI:1578838553
Name:COMMONWEALTH ONCOLOGY GROUP, LLC
Entity Type:Organization
Organization Name:COMMONWEALTH ONCOLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-596-6000
Mailing Address - Street 1:2876 GUARDIAN LN
Mailing Address - Street 2:ACSEL CORPORATION
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7327
Mailing Address - Country:US
Mailing Address - Phone:757-463-5240
Mailing Address - Fax:757-463-6572
Practice Address - Street 1:6801 GOV. G. C. PEERY HWY.
Practice Address - Street 2:CLINCH VALLEY MEDICAL CENTER
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2194
Practice Address - Country:US
Practice Address - Phone:276-596-6000
Practice Address - Fax:276-596-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010419052085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty