Healthcare Provider Details

I. General information

NPI: 1457393126
Provider Name (Legal Business Name): TENNESSEE ONCOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

397 WALLACE RD
NASHVILLE TN
37211-8025
US

IV. Provider business mailing address

300 20TH AVE N SUITE 301
NASHVILLE TN
37203
US

V. Phone/Fax

Practice location:
  • Phone: 615-333-2481
  • Fax: 615-781-3923
Mailing address:
  • Phone: 615-986-4102
  • Fax: 615-750-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberMD28524
License Number StateTN

VIII. Authorized Official

Name: PATTIE DOUGLAS
Title or Position: PAYER RELATIONS MANAGER
Credential:
Phone: 615-514-3042