Provider Demographics
NPI:1538324587
Name:CANTRELL, STEPHEN BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BENJAMIN
Last Name:CANTRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MALLORY LN STE 103
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8234
Mailing Address - Country:US
Mailing Address - Phone:615-807-1037
Mailing Address - Fax:615-236-9945
Practice Address - Street 1:2001 MALLORY LN STE 103
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8234
Practice Address - Country:US
Practice Address - Phone:615-807-1037
Practice Address - Fax:615-236-9945
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41892207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology