Basic Information
Provider Information
NPI: 1376553529
EntityType: 2
ReplacementNPI:  
OrganizationName: ONCOLOGIC SPECIALISTS PC
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Mailing Information
Address1: PO BOX 72239
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441920002
CountryCode: US
TelephoneNumber: 3149918200
FaxNumber: 3145691787
Practice Location
Address1: 1080 HARRINGTON ST
Address2:  
City: MOUNT CLEMENS
State: MI
PostalCode: 480432901
CountryCode: US
TelephoneNumber: 5864937510
FaxNumber: 5864937511
Other Information
ProviderEnumerationDate: 08/09/2006
LastUpdateDate: 12/17/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: FRAZIER
AuthorizedOfficialFirstName: ARTHUR
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5864937510
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate: 12/17/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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