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General NPI Number Information
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NPI Number | 1881880961
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Entity Type | Organization
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Legal Business Name | COLUMBIA RADIATION ONCOLOGY
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 509 E BELL ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-3059
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Country | US
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Telephone | 615-396-5530
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Fax | 615-382-8056
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Provider Business Mailing Address
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Address Line | PO BOX 968
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City | SPRINGFIELD
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State | TN
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Zip | 37172-0968
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Country | US
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Telephone | 615-382-8863
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Fax | 615-382-8056
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. CHARLES D WENDT
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Credential | M.D.
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Telephone | 615-396-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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