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Organization

PROGRESSIVE RADIATION ONCOLOGY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARREL L ROSS MD (OWNER)
(317) 863-2593
Entity
Organization

Contact information

Practice address
2020 MERIDIAN ST, SUITE 100, ANDERSON, IN 46016-4346
(317) 863-2593
(317) 863-2602
Mailing address
PO BOX 730, FISHERS, IN 46038-0730
(317) 863-2593
(317) 863-2602

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01060645
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000523109
ANTHEM GROUP #
IN
01
1679668735
INDIVIDUAL NPI
IN
01
1801956867
GROUP NPI
IN
05
200371400
IN
05
200868590A
IN
Enumeration date
12/11/2006
Last updated
05/27/2008
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