Provider Demographics
NPI:1942902077
Name:CANCER CARE GROUP, P.C.
Entity Type:Organization
Organization Name:CANCER CARE GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FREELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-715-1800
Mailing Address - Street 1:6100 W 96TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-6006
Mailing Address - Country:US
Mailing Address - Phone:317-715-1800
Mailing Address - Fax:
Practice Address - Street 1:1425 UNITY PL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5756
Practice Address - Country:US
Practice Address - Phone:765-447-7460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty