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Organization
VIDA ONCOLOGY LLC
Active
Organization
VIDA ONCOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME AYON MD (OWNER)
(317) 796-2200
Entity
Organization
Contact information
Practice address
2150 INTELLIPLEX DR STE 134, SHELBYVILLE, IN 46176-8550
(317) 796-2200
Mailing address
2150 INTELLIPLEX DR STE 134, SHELBYVILLE, IN 46176-8550
(317) 796-2200
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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