Healthcare Provider Details
I. General information
NPI: 1821205451
Provider Name (Legal Business Name): TENNESSEE ONCOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 25TH AVE N STE 310
NASHVILLE TN
37203-1632
US
IV. Provider business mailing address
PO BOX 440100
NASHVILLE TN
37244-0100
US
V. Phone/Fax
- Phone: 615-986-7600
- Fax:
- Phone: 615-329-0570
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATTIE
DOUGLAS
Title or Position: PAYER RELATIONS MANAGER
Credential:
Phone: 615-514-6876