Organization
COOS RADIOSURGERY GROUP LLC
Active
Organization
COOS RADIOSURGERY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN G FULLER MD (MANAGER)
(301) 529-7222
Entity
Organization
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8520
Mailing address
PO BOX 398974, SAN FRANCISCO, CA 94139-8974
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
03/09/2018
Last updated
03/22/2018
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