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General NPI Number Information
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NPI Number | 1922181114
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Entity Type | Organization
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Legal Business Name | TENNESSEE CANCER SPECIALISTS
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 7551 DANNAHER WAY
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City | POWELL
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State | TN
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Zip | 37849-4029
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Country | US
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Telephone | 865-637-9330
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Fax | 865-512-6748
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Provider Business Mailing Address
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Address Line | 900 E HILL AVE STE 230
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City | KNOXVILLE
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State | TN
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Zip | 37915-2566
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Country | US
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Telephone | 865-862-0998
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Fax | 865-544-1861
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Authorized Official
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Title or Position | CHIEF MANAGER
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Name | MITCHELL D MARTIN
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Credential | M.D.
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Telephone | 865-637-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 4453298
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License Number State | TN
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