Provider Demographics
NPI:1972708915
Name:RADIATION ONCOLOGY MEMPHIS PLLC
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY MEMPHIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:901-821-0338
Mailing Address - Street 1:PO BOX 2044
Mailing Address - Street 2:DEPT 2600
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-2044
Mailing Address - Country:US
Mailing Address - Phone:901-821-0338
Mailing Address - Fax:901-821-0341
Practice Address - Street 1:5959 PARK AVE
Practice Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5200
Practice Address - Country:US
Practice Address - Phone:901-821-0338
Practice Address - Fax:901-821-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000362092085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Single Specialty