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General NPI Number Information
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NPI Number | 1144504457
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Entity Type | Organization
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Legal Business Name | BOSTON BASKIN CANCER FOUNDATION, INC
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 80 HUMPHREYS CENTER DR STE 330
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City | MEMPHIS
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State | TN
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Zip | 38120-2363
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Country | US
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Telephone | 901-752-6131
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Fax | 901-752-6167
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Provider Business Mailing Address
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Address Line | PO BOX 405827
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City | ATLANTA
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State | GA
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Zip | 30384-9446
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Country | US
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Telephone |
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Fax | 901-227-8591
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS W RATLIFF
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Credential | MD
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Telephone | 901-767-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 31689
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License Number State | TN
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