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General NPI Number Information
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NPI Number | 1962589150
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Entity Type | Organization
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Legal Business Name | EAST TENNESSEE RADIATION ONCOLOGY, P.C.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/03/2023
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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 | 865-541-1155
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Fax | 865-988-5658
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Provider Business Mailing Address
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Address Line | PO BOX 24120
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City | KNOXVILLE
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State | TN
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Zip | 37933-2120
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Country | US
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Telephone | 865-803-4321
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Fax | 865-988-5658
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | JANIE L JOHNSON
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Credential |
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Telephone | 865-803-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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