Basic Information
| Provider Information | |||||||||
| NPI: | 1013384056 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE ONCOLOGY OF ALABAMA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18201 VON KARMAN AVE STE 600 | ||||||||
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| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926121176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1110 S JACKSON HWY | ||||||||
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| City: | SHEFFIELD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356605747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563835211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2015 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | LARKIN | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8005443215 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.