Provider Demographics
NPI:1831186014
Name:RADIATION ONCOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LINEBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-664-3914
Mailing Address - Street 1:PO BOX 56409
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-6409
Mailing Address - Country:US
Mailing Address - Phone:501-296-3273
Mailing Address - Fax:501-664-8721
Practice Address - Street 1:CARTI MARKHAM & UNIVERSITY
Practice Address - Street 2:#4 ST. VINCENT CIRCLE
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-296-3273
Practice Address - Fax:501-664-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC17382085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
57423Medicare ID - Type Unspecified