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MONTGOMERY CANCER CENTER LLC NPI 1962652180


NPI Information

NPI: 1962652180
Provider Name: MONTGOMERY CANCER CENTER, LLC
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
1023 MEDICAL CENTER PKWY
SUITE 110
SELMA, AL
ZIP 36701
Phone: (334) 872-9300
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MONTGOMERY CANCER CENTER, LLC is a hematology and oncology internal medicine in Selma, AL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. MONTGOMERY CANCER CENTER, LLC NPI is 1962652180. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1023 MEDICAL CENTER PKWY
SUITE 110
SELMA, AL
ZIP 36701-780
Phone: (334) 872-9300

The provider's authorized official is Venty Butts .
The authorized official title is Ceo and has the following contact phone number (334) 273-2285.

The enumeration date for this NPI number is 9/24/2008 and was last updated on 9/24/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RX0202XInternal MedicineMedical OncologyNo
22085R0001XRadiologyRadiation OncologyNo
3207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14248810004MEDICARE NSC
2F836MEDICARE PINALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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