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Organization

INTEGRATED COMMUNITY ONCOLOGY NETWORK

Active
Other names
Southeast Georgia Radiation Oncology
Organization subpart
No

Provider details

NPI number
Authorized official
SHYAM PARYANI MD (DIRECTOR)
(904) 346-3338
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DD1817
MEDICARE RAILROAD
GA
01
DD1990
MEDICARE RAILROAD
GA
Enumeration date
07/12/2006
Last updated
10/31/2007
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