Poplar Bluff Cancer & Radiation Specialist LLC

Primary specialty

Therapeutic Radiology PhysicianTaxonomy code 2085R0203X

Legal business name

POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC

Practice address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Phone

(573) 686-5300

NPI assigned

Jan 30, 2007

Last updated

May 24, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Subhash Gujarati, M.D.NPI 1700941242

Title

Physician

Phone

(573) 686-5300

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Subhash Gujarati, M.D.

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1700941242
  NPD (past) Authorized official
• Narayana G Memula, M.D.

  • Therapeutic Radiology Physician
  • San Bernardino, CA
  • NPI 1568478238
  NPD (past)
• Emily Louise Militzer, M.D.

  • Radiation Oncology Physician
  • Farmington, NM
  • NPI 1962431007
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1104963354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 958262",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631958262",
            "telephone_number": "636-207-0537",
            "fax_number": "636-207-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-686-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "GUJARATI",
        "authorized_official_first_name": "SUBHASH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "573-686-5300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711887000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Megan Victoria Pold, DPT
• Sherri M Ponder
• Velmathy Ponnambalam, MD
• Poplar Bluff Children's Dentistry, LLC
• Poplar Bluff Emergency Physicians, LLC
• Poplar Bluff Hma Physician Management, LLC
• Poplar Bluff Medical Partners, LLC
• Poplar Bluff Neurology Center, PC

• Therapeutic Radiology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Therapeutic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.