Provider Demographics
NPI:1770967598
Name:MIDNIGHT SUN ONCOLOGY PARTNERS, LLC
Entity type:Organization
Organization Name:MIDNIGHT SUN ONCOLOGY PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUTERBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-969-8654
Mailing Address - Street 1:4220 CAHABA HEIGHTS CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5730
Mailing Address - Country:US
Mailing Address - Phone:205-969-8654
Mailing Address - Fax:205-972-8166
Practice Address - Street 1:2490 S WOODWORTH LOOP
Practice Address - Street 2:SUITE 499
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7410
Practice Address - Country:US
Practice Address - Phone:907-746-7771
Practice Address - Fax:907-746-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty