MEDICARE: TENNESSEE ONCOLOGY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician
2	207RX0202X	Medical Oncology Physician

General Provider Information

NPI Number	:	1881212553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENNESSEE ONCOLOGY, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 440100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0100
Country	:	US
Telephone Number	:	615-329-0570
Fax Number	:	615-329-0579

Provider Business Practice Location Address
First Line	:	4645 BATTLEFIELD PKWY
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-8011
Country	:	US
Telephone Number	:	423-648-2362
Fax Number	:	423-648-9294

Authorized Official
Title or Position	:	PAYER RELATIONS MANAGER
Name	:	PATTIE Y DOUGLAS
Credential	:
Telephone Number	:	615-514-6876

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	07/09/2020

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