Organization
PIKES PEAK RADIATION ONCOLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK B HAZUKA M.D. (PRESIDENT)
(719) 570-7675
Entity
Organization
Contact information
Practice address
1425 N UNION BLVD, SUITE 202, COLORADO SPRINGS, CO 80909-2871
(719) 570-7675
(719) 471-9314
Mailing address
1425 N UNION BLVD, SUITE 202, COLORADO SPRINGS, CO 80909-2871
(719) 570-7675
(719) 471-9314
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04017968
—
CO
01
—
40421
BCBS
CO
Enumeration date
01/17/2006
Last updated
08/22/2020
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