Organization
NORTHERN ARIZONA RADIATION ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW K DAVID M.D. (PRESIDENT)
(928) 204-4160
Entity
Organization
Contact information
Practice address
1200 N. BEAVER STREET, CANCER CENTER OF NORTHERN ARIZONA, FLAGSTAFF, AZ 86001
(928) 773-2261
Mailing address
PO BOX 749560, LOS ANGELES, CA 90074-9560
(770) 693-2622
(770) 693-6039
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010949804
—
AZ
05
—
109498
—
AZ
01
—
DC8937
RR MEDICARE
AZ
Enumeration date
11/10/2005
Last updated
08/23/2011
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