Provider Demographics
NPI:1780657767
Name:ONCOTHERAPEUTIC RESOURCES PA
Entity Type:Organization
Organization Name:ONCOTHERAPEUTIC RESOURCES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:CALKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-870-4160
Mailing Address - Street 1:PO BOX 152077
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-2077
Mailing Address - Country:US
Mailing Address - Phone:813-870-4160
Mailing Address - Fax:813-554-8991
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4160
Practice Address - Fax:813-554-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056868600Medicaid
FL24361Medicare ID - Type UnspecifiedGROUP NUMBER