Provider Demographics
NPI:1790041754
Name:TAYLOR REGIONAL RADIATION ONCOLOGY PLLC
Entity type:Organization
Organization Name:TAYLOR REGIONAL RADIATION ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-789-9999
Mailing Address - Street 1:7240 SOLUTION CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-7002
Mailing Address - Country:US
Mailing Address - Phone:866-353-0360
Mailing Address - Fax:615-296-0952
Practice Address - Street 1:125 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9616
Practice Address - Country:US
Practice Address - Phone:270-789-9999
Practice Address - Fax:270-789-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty