Organization
PUEBLO RADIATION ONCOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D STAGEBERG M.D. (PHYSICIAN)
(719) 560-5482
Entity
Organization
Contact information
Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 560-5482
(719) 560-7217
Mailing address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 560-5482
(719) 560-7217
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04006318
—
CO
Enumeration date
04/17/2006
Last updated
07/18/2013
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