Provider Demographics
NPI:1609602473
Name:TENNESSEE ONCOLOGY PLLC
Entity type:Organization
Organization Name:TENNESSEE ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYER RELATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-514-6876
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:2004 HAYES ST STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2699
Practice Address - Country:US
Practice Address - Phone:615-284-4646
Practice Address - Fax:615-284-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3709319Medicaid