Healthcare Provider Details

I. General information

NPI: 1538364385
Provider Name (Legal Business Name): KIMSEY RADIATION ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 GLENWOOD DR SUITE 208
CHATTANOOGA TN
37404-1108
US

IV. Provider business mailing address

605 GLENWOOD DR SUITE 208
CHATTANOOGA TN
37404-1108
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-7736
  • Fax: 423-495-7718
Mailing address:
  • Phone: 423-495-7736
  • Fax: 423-495-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD0000020775
License Number StateTN

VIII. Authorized Official

Name: DR. FRANK C KIMSEY
Title or Position: OWNER
Credential: MD
Phone: 423-756-5329