Provider Demographics
NPI:1861797920
Name:CANCER CARE CENTER PC
Entity type:Organization
Organization Name:CANCER CARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-353-5151
Mailing Address - Street 1:1310 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4347
Mailing Address - Country:US
Mailing Address - Phone:256-353-5151
Mailing Address - Fax:256-351-9915
Practice Address - Street 1:1310 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4347
Practice Address - Country:US
Practice Address - Phone:256-353-5151
Practice Address - Fax:256-351-9915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25921207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty