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General NPI Number Information
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NPI Number | 1639113061
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Entity Type | Organization
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Legal Business Name | THOMPSON CANCER SURVIVAL CENTER
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1915 WHITE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-2300
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Country | US
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Telephone | 865-541-1485
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Fax | 865-541-2564
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Provider Business Mailing Address
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Address Line | 1915 WHITE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-2300
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Country | US
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Telephone | 865-541-1485
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Fax | 865-541-2564
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Authorized Official
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Title or Position | VICE PRESIDENT, CFO
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Name | MRS. MITZI ANDERSON
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Credential |
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Telephone | 865-541-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | 00000196
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | 00000171
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License Number State | TN
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