Provider Demographics
NPI:1316178577
Name:ATHENS REGIONAL CANCER CENTER PLLC
Entity Type:Organization
Organization Name:ATHENS REGIONAL CANCER CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VIROSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-472-2171
Mailing Address - Street 1:680 S WHITE ST
Mailing Address - Street 2:P.O. BOX 1814
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-4609
Mailing Address - Country:US
Mailing Address - Phone:423-252-1580
Mailing Address - Fax:423-472-0060
Practice Address - Street 1:680 S WHITE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4609
Practice Address - Country:US
Practice Address - Phone:423-252-1580
Practice Address - Fax:423-472-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN204261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation