National Provider Identifier Database

POPLAR BLUFF CANCER RADIATION SPECIALIST LLC
Radiation Oncology

January 1, 2025 - Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.


Contact Information

POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO63901-3396
Phone: 573-686-5300
Fax:
Website:
Specialty Taxonomy Code
* Radiation Oncology 2085R0203X

* Indicates primary specialty

NPI Profile & details for POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC

NPI Number 1104963354
Legal business name
LBN
POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC
Authorized official SUBHASH GUJARATI - (PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 01/30/2007
Last updated 05/24/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 711887000

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC

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