Provider Demographics
NPI:1285624163
Name:OHIO RADIATION ONCOLOGY, INC.
Entity type:Organization
Organization Name:OHIO RADIATION ONCOLOGY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHWIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-273-2656
Mailing Address - Street 1:3801 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3023
Mailing Address - Country:US
Mailing Address - Phone:330-273-2656
Mailing Address - Fax:330-273-3755
Practice Address - Street 1:3801 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3023
Practice Address - Country:US
Practice Address - Phone:330-273-2656
Practice Address - Fax:330-273-3755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0713RT174400000X
OH10151C174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH920002001OtherRAILROAD MEDICARE
OH000000162008OtherOHIO OPERATING ENGINEERS
OH000000162008OtherANTHEM
OH0101624Medicaid
OH0101624Medicaid
OH9270691Medicare PIN