Provider Demographics
NPI:1629248372
Name:LAWRENCE RADIATION ONCOLOGY LLC
Entity Type:Organization
Organization Name:LAWRENCE RADIATION ONCOLOGY LLC
Other - Org Name:PRECISION CANCER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER/ MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-749-3600
Mailing Address - Street 1:330 ARKANSAS
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1335
Mailing Address - Country:US
Mailing Address - Phone:785-749-3600
Mailing Address - Fax:785-749-3621
Practice Address - Street 1:330 ARKANSAS
Practice Address - Street 2:SUITE 120
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1485
Practice Address - Country:US
Practice Address - Phone:785-749-3600
Practice Address - Fax:785-749-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0431633174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200656390AMedicaid
KSKA1095Medicare UPIN