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Organization

RADIATION ONCOLOGY ST MARY PLACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LANE ROSEN MD (MD OWNER)
(318) 222-1149
Entity
Organization

Contact information

Practice address
ONE SAINT MARY PLACE, CANCER TREATMENT CENTER, SHREVEPORT, LA 71101-4343
(318) 681-4126
Mailing address
PO BOX 9600, DEPT 09 042, TEXARKANA, TX 75505

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
022404
LA

Other

Enumeration date
04/26/2007
Last updated
05/21/2008
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