Provider Demographics
NPI:1831604156
Name:RUSSELL ONCOLOGY JV PHYSICIANS SERVICES LLC
Entity type:Organization
Organization Name:RUSSELL ONCOLOGY JV PHYSICIANS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOTHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEACE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:256-329-7100
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35011-0939
Mailing Address - Country:US
Mailing Address - Phone:256-329-7100
Mailing Address - Fax:
Practice Address - Street 1:3316 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3369
Practice Address - Country:US
Practice Address - Phone:256-329-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty