Basic Information
Provider Information
NPI: 1023458403
EntityType: 2
ReplacementNPI:  
OrganizationName: TENNESSEE CANCER SPECIALISTS
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 10988
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379390988
CountryCode: US
TelephoneNumber: 8658620998
FaxNumber: 8655441861
Practice Location
Address1: 2525 DESALES AVENUE
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374141102
CountryCode: US
TelephoneNumber: 4233390300
FaxNumber: 4234725687
Other Information
ProviderEnumerationDate: 06/28/2013
LastUpdateDate: 08/28/2013
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: DOBBS
AuthorizedOfficialFirstName: TRACY
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: CHIEF MANAGER
AuthorizedOfficialTelephone: 8659345800
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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