Provider Demographics
NPI:1740372002
Name:RADIATION ONCOLOGY ASSOCIATES OF N.E. TN
Entity type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES OF N.E. TN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION ONCOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-224-5500
Mailing Address - Street 1:P O BOX 1183
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088
Mailing Address - Country:US
Mailing Address - Phone:615-449-9680
Mailing Address - Fax:615-449-9390
Practice Address - Street 1:130 WEST RAVINE ROAD
Practice Address - Street 2:RADIATION ONCOLOGY DEPT
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-224-5500
Practice Address - Fax:423-224-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3701427Medicaid
TN=========OtherCOMMERCIAL CLAIMS
TN3701427Medicaid
VARAILROAD MEDICAREMedicare ID - Type UnspecifiedCM8900
TN3701427Medicare ID - Type Unspecified
TN=========OtherCOMMERCIAL CLAIMS
TN3701427Medicaid