Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Other names
ICON Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A MARSLAND M.D. (PRESIDENT)
(904) 276-2303
Entity
Organization
Contact information
Practice address
600 ZEAGLER DRIVE, SUITE 1, PALATKA, FL 32177
(386) 325-8140
(386) 325-2214
Mailing address
3599 UNIVERSITY AVENUE, SUITE 805, JACKSONVILLE, FL 32216
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273427302
—
FL
01
—
94890
BCBS
FL
Enumeration date
10/03/2005
Last updated
11/28/2012
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