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NPI Code Detail

MEDICARE: CANCER CARE RESOURCE MANAGEMENT, LLC

MEDICARE: CANCER CARE RESOURCE MANAGEMENT, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician

General Provider Information

NPI Number : 1720191943
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANCER CARE RESOURCE MANAGEMENT, LLC
Provider Business Mailing Address
First Line : 4851 S INTERSTATE 35 E
Second Line : SUITE 101
City : CORINTH
State : TX
Zip : 76210-2348
Country : US
Telephone Number : 940-270-5000
Fax Number : 940-269-5001
Provider Business Practice Location Address
First Line : 4851 S INTERSTATE 35 E
Second Line : SUITE 101
City : CORINTH
State : TX
Zip : 76210-2348
Country : US
Telephone Number : 940-270-5000
Fax Number : 940-269-5001
Authorized Official
Title or Position : MANAGER
Name : ODETTE L CAMPBELL
Credential : MD
Telephone Number : 940-270-5000
Provider Enumeration Date : 08/15/2006
Last Update Date : 08/22/2020

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Directions to “CANCER CARE RESOURCE MANAGEMENT, LLC ” Practice Location

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