Organization
HENDERSON CANCER CENTER PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALVIN NONE KORBA MEDICAL DOCTOR (PRESIDENT)
(270) 826-0255
Entity
Organization
Contact information
Practice address
1401 N ELM ST, HENDERSON, KY 42420-2784
(270) 827-0255
(270) 826-5342
Mailing address
PO BOX 15040, EVANSVILLE, IN 47716-0040
(812) 476-1367
(812) 477-4153
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65913774
—
KY
01
—
CA0138
RR MEDICARE
KY
Enumeration date
05/08/2006
Last updated
09/15/2008
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