Healthcare Provider Details

I. General information

NPI: 1619975737
Provider Name (Legal Business Name): THOMPSON ONCOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 WHITE AVE
KNOXVILLE TN
37916-2300
US

IV. Provider business mailing address

1915 WHITE AVE
KNOXVILLE TN
37916-2300
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-1720
  • Fax: 865-541-2451
Mailing address:
  • Phone: 865-541-1720
  • Fax: 865-541-2451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MITZI ANDERSON JR.
Title or Position: CFO
Credential:
Phone: 865-331-1720