Provider Demographics
NPI:1831161843
Name:RADIATION ONCOLOGY SPECIALISTS OF CENTRAL VIRGINIA PLC
Entity type:Organization
Organization Name:RADIATION ONCOLOGY SPECIALISTS OF CENTRAL VIRGINIA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:B
Authorized Official - Last Name:SPRENKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-266-8717
Mailing Address - Street 1:PO BOX 31872
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-1872
Mailing Address - Country:US
Mailing Address - Phone:804-266-8717
Mailing Address - Fax:804-266-5677
Practice Address - Street 1:6105 HEALTH CENTER LANE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407
Practice Address - Country:US
Practice Address - Phone:540-786-5262
Practice Address - Fax:540-786-5299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA5692OtherRAILROAD MEDICARE
DA5692OtherRAILROAD MEDICARE