Healthcare Provider Details

I. General information

NPI: 1740234590
Provider Name (Legal Business Name): TENNESSEE ONCOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S HARTMANN DR STE 340
LEBANON TN
37090-4101
US

IV. Provider business mailing address

PO BOX 440100
NASHVILLE TN
37244-0100
US

V. Phone/Fax

Practice location:
  • Phone: 615-784-4039
  • Fax: 615-871-9682
Mailing address:
  • Phone: 615-329-0570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PATTIE DOUGLAS
Title or Position: PAYER RELATIONS MANAGER
Credential:
Phone: 615-514-6876