Provider Demographics
NPI:1255360459
Name:SMITHFIELD RADIATION ONCOLOGY, LLC
Entity type:Organization
Organization Name:SMITHFIELD RADIATION ONCOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CIELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-938-6629
Mailing Address - Street 1:514 N BRIGHTLEAF BLVD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4407
Mailing Address - Country:US
Mailing Address - Phone:919-209-3555
Mailing Address - Fax:919-938-7400
Practice Address - Street 1:514 N BRIGHTLEAF BLVD
Practice Address - Street 2:SUITE 1200
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4486
Practice Address - Country:US
Practice Address - Phone:919-209-3555
Practice Address - Fax:919-938-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016RJOtherBLUE CROSS/BLUE SHIELD
NC89016RJMedicaid
NC89016RJMedicaid