Organization
RIVERSIDE RADIATION ONCOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J CRNKOVICH MD (PRESIDENT)
(614) 566-5000
Entity
Organization
Contact information
Practice address
3525 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3937
(614) 566-5000
(614) 566-6958
Mailing address
PO BOX 182039, DEPT 086, COLUMBUS, OH 43218-2039
(614) 430-5712
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0649436
—
OH
01
—
CB5260
MEDICARE RAILROAD
—
Enumeration date
06/21/2006
Last updated
08/22/2011
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