Provider Demographics
NPI:1679847917
Name:EAST TENNESSEE RADIATION THERAPY
Entity Type:Organization
Organization Name:EAST TENNESSEE RADIATION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CLINICAL OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WARWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-684-2613
Mailing Address - Street 1:PO BOX 50310
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-0310
Mailing Address - Country:US
Mailing Address - Phone:865-684-2613
Mailing Address - Fax:865-684-2611
Practice Address - Street 1:1415 OLD WEISGARBER RD
Practice Address - Street 2:SUITE 250
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1327
Practice Address - Country:US
Practice Address - Phone:865-684-2613
Practice Address - Fax:865-684-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty