| NPI | 1891317509 |
|---|---|
| Doing Business As | SOUTH COUNTY MEDICAL GROUP RADIATION ONCOLOGY |
| Entity Type | Organization |
| Authorized Contact | KACE QUINN Payor Credentialing Specialist 401-788-8757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |