Provider Demographics
NPI:1760514558
Name:REGIONAL RADIATION ONCOLOGY CARE, PC
Entity Type:Organization
Organization Name:REGIONAL RADIATION ONCOLOGY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-630-1716
Mailing Address - Street 1:PO BOX 1946
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69363-1946
Mailing Address - Country:US
Mailing Address - Phone:308-630-1716
Mailing Address - Fax:308-630-1445
Practice Address - Street 1:3911 AVENUE B
Practice Address - Street 2:SUITE G-1OO
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4617
Practice Address - Country:US
Practice Address - Phone:308-630-1716
Practice Address - Fax:308-630-1445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE192192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty