# WILLIAMSBURG RADIATION THERAPY CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE PHYSICIAN SERVICES INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144387655
- **Legal business name:** RIVERSIDE PHYSICIAN SERVICES INC
- **Authorized official:** MICHAEL DOUCETTE (VICE PRESIDENT)
- **Authorized official phone:** (757) 594-4006

## Contact information

- **Practice address:** 3901 TREYBURN DR, SUITE B, WILLIAMSBURG, VA 23185-2891
- **Practice address phone:** (757) 220-4900
- **Practice address fax:** (757) 565-5328
- **Mailing address:** 856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 594-4006
- **Mailing address fax:** (757) 594-2195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 02/01/2008