Healthcare Provider Details
I. General information
NPI: 1730130436
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: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 S MOUNT JULIET RD STE 230
MT JULIET TN
37122-3923
US
IV. Provider business mailing address
PO BOX 440100
NASHVILLE TN
37244-0100
US
V. Phone/Fax
- Phone: 615-874-9667
- Fax:
- Phone: 615-329-0570
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP1100X |
| Taxonomy | Podiatric Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATTIE
Y
DOUGLAS
Title or Position: PAYER RELATIONS MGR
Credential:
Phone: 615-514-6876