Provider Demographics
NPI:1770616658
Name:REGIONAL RADIATION ONCOLOGY CARE, PC
Entity type:Organization
Organization Name:REGIONAL RADIATION ONCOLOGY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-630-1716
Mailing Address - Street 1:PO BOX 2116
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69363-2116
Mailing Address - Country:US
Mailing Address - Phone:308-630-1716
Mailing Address - Fax:308-630-1445
Practice Address - Street 1:830 PINE ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2284
Practice Address - Country:US
Practice Address - Phone:308-630-1716
Practice Address - Fax:308-630-1445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE192192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty