Basic Information
| Provider Information | |||||||||
| NPI: | 1952358053 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARTLAND RADIATION ONCOLOGY, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2455 INTELLIPLEX DR | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461768535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742712558 | ||||||||
| FaxNumber: | 5742731137 | ||||||||
| Practice Location | |||||||||
| Address1: | 2455 INTELLIPLEX DR | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461768535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742712558 | ||||||||
| FaxNumber: | 5742731137 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RHEES | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5742712558 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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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.