Organization
BAY AREA RADIATION ONCOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A HENDERSON MD (OWNER)
(317) 490-8457
Entity
Organization
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8520
(541) 267-5083
Mailing address
PO BOX 3166, PORTLAND, OR 97208-3166
(541) 269-8520
(541) 267-5083
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD166373
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500675118
—
OR
01
—
MD166373
STATE MEDICAL LICENSE
OR
Enumeration date
03/14/2014
Last updated
04/25/2016
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