POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC
NPI 1104963354
Radiology - Therapeutic Radiology in Poplar Bluff, MO

Active since January 30, 2007
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901(573) 686-5300 Get Directions Write a Review

NPPES record last updated: May 24, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Poplar Bluff Cancer & Radiation Specialist Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

POPLAR BLUFF CANCER & RADIATION SPECIALIST LLC (NPI 1104963354) is a healthcare organization registered as a therapeutic radiology in Poplar Bluff, Missouri and active in the NPI registry since January 2007. The organization lists Subhash Gujarati, Physician, as its authorized official.

NPPES Registry Identity

NPI1104963354
Entity TypeOrganization
Primary Taxonomy2085R0203X
Legal Business NamePOPLAR BLUFF CANCER & RADIATION SPECIALIST LLC
Location Address2620 N WESTWOOD BLVDPoplar Bluff, MO 63901-3396
Mailing AddressPo Box 958262Saint Louis, MO 63195-8262 · (636) 207-0537 · Fax (636) 207-0221
Organization SubpartNo
Authorized OfficialSubhash GujaratiPhysician · (573) 686-5300
Enumeration DateJanuary 30, 2007
Last NPPES UpdateMay 24, 2010
NPI 1104963354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Therapeutic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0203X
Definition

Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.

2620 N WESTWOOD BLVD, Poplar Bluff, MO 63901

Other Identifiers 2

Medicare ID-Type Unspecified000014782MO · Medicare Clinic Number
Medicaid711887000MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Nurse Practitioner (Family)
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Hospitalist
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Nurse Anesthetist, Certified Registered
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Emergency Medicine
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Nurse Anesthetist, Certified Registered
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Emergency Medicine
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Psychiatry & Neurology (Psychiatry)
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Poplar Bluff Cancer & Radiation Specialist LLC's NPI number?

The NPI number for Poplar Bluff Cancer & Radiation Specialist LLC is 1104963354. It was assigned to this organization in the NPPES registry on January 30, 2007.

Where is Poplar Bluff Cancer & Radiation Specialist LLC located?

Poplar Bluff Cancer & Radiation Specialist LLC is located at 2620 N Westwood Blvd, Poplar Bluff, MO 63901. The listed phone number is (573) 686-5300.

What is Poplar Bluff Cancer & Radiation Specialist LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Therapeutic Radiology, with taxonomy code 2085R0203X.

When was this NPI record last updated?

The NPPES record for Poplar Bluff Cancer & Radiation Specialist LLC was last updated on May 24, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.