Unknown Individual – Radiation Oncology Physician, NPI 1922004431

Unknown Individual is a healthcare provider. based in Fort payne, Alabama. specializing in Radiation Oncology Physician. They hold a License No. 9616 (AL). The NPI Number for Unknown Individual is 1922004431

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922004431
Phone
(256) 845-3500
Address
1608 GLENN BLVD SW
Deactivation Date
28 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Secondary Phone
2057833000
Graduation Year
1968 (58 years ago)
PAC ID
0749194470
Group Practice PAC ID
8022922756
Professional Enrollment ID
I20040521000765
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1608, Glenn Boulevard Southwest, Fort Payne, DeKalb County, Alabama, 35968, United States

    FORT PAYNE, AL 359683522

    Phone: (256) 845-3500

    Fax: (256) 997-9208

    Type: Location

  • Afflink Place, 2nd Avenue Northeast, Dunbrook, Tuscaloosa, Tuscaloosa County, Alabama, 35406, United States

    SUITE 100

    TUSCALOOSA, AL 354062289

    Phone: (205) 366-9740

    Fax: (205) 344-9992

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35968)

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Provider's Procedures

Unknown Individual performs procedures in Radiation Oncology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
RADIATION ONCOLOGYAL77263Management of radiation therapy, complex2019

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022922756View full group profile
NameSpecialtyState
BRYAN E BILLIONS (MD)
Diagnostic RadiologyAL
RICARDO BRACER (MD)
Diagnostic RadiologyAL
DR. STEPHANIE L DENHAM (M.D.)
Diagnostic RadiologyAL
DR. ROBERT FULMER III GARNER (M.D.)
-AL
DR. JOSEPH H JR. EMBRY (M.D.)
Diagnostic RadiologyAL
ARTHUR A III JONES (MD)
-AL
JOSEPH BILL EASON (M.D.)
Diagnostic Radiology, Interventional RadiologyAL
BENJAMIN GLASGOW JR. MCDANIEL (MD)
-AL
LAURA DOVER (MD, MSPH)
Radiation OncologyAL
DR. THADDEUS FRAZELL COLEMAN (MD)
Diagnostic RadiologyAL

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1922004431 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Radiation Oncology Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Fort Payne, Alabama. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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