Provider Demographics
NPI:1154709673
Name:FJS RADIATION ONCOLOGY INC
Entity type:Organization
Organization Name:FJS RADIATION ONCOLOGY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:PIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-378-2449
Mailing Address - Street 1:2675 N DECATUR RD
Mailing Address - Street 2:G03
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6131
Mailing Address - Country:US
Mailing Address - Phone:770-378-2449
Mailing Address - Fax:404-759-2167
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:G03
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:770-378-2449
Practice Address - Fax:404-759-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-16
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA424242085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty