Provider Demographics
NPI:1497739478
Name:NEWARK RADIATION ONCOLOGY, INC.
Entity type:Organization
Organization Name:NEWARK RADIATION ONCOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDNALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-344-3100
Mailing Address - Street 1:115 MCMILLEN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1808
Mailing Address - Country:US
Mailing Address - Phone:740-344-3100
Mailing Address - Fax:740-344-5793
Practice Address - Street 1:115 MCMILLEN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1808
Practice Address - Country:US
Practice Address - Phone:740-687-8550
Practice Address - Fax:740-687-8959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX ID