Provider Demographics
NPI:1598781114
Name:MCKENNA RADIATION ONCOLOGY GROUP PC
Entity Type:Organization
Organization Name:MCKENNA RADIATION ONCOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-398-5994
Mailing Address - Street 1:PO BOX 241359
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-5359
Mailing Address - Country:US
Mailing Address - Phone:402-398-5994
Mailing Address - Fax:402-398-5978
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:DEPT OF RADIATION ONCOLOGY
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-398-6485
Practice Address - Fax:402-398-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty