Healthcare Provider Details

I. General information

NPI: 1992756779
Provider Name (Legal Business Name): TENNESSEE ONCOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1589 SPARTA ST STE 203
MCMINNVILLE TN
37110-1332
US

IV. Provider business mailing address

PO BOX 440100
NASHVILLE TN
37244-0100
US

V. Phone/Fax

Practice location:
  • Phone: 931-815-3665
  • Fax:
Mailing address:
  • Phone: 615-329-0570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

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