# INTEGRATED COMMUNITY ONCOLOGY NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeast Georgia Radiation Oncology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194750315
- **Authorized official:** SHYAM PARYANI MD (DIRECTOR)
- **Authorized official phone:** (904) 346-3338

## Contact information

- **Practice address:** 2500 STARLING ST, SUITE 107, BRUNSWICK, GA 31520-4265
- **Practice address phone:** (912) 466-5100
- **Practice address fax:** (912) 466-5113
- **Mailing address:** 2500 STARLING ST, SUITE 107, BRUNSWICK, GA 31520-4265
- **Mailing address phone:** (912) 466-5100
- **Mailing address fax:** (912) 466-5113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | — | NULL | Yes |
| 173000000X | Legal Medicine | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 10/31/2007