Basic Information
| Provider Information | |||||||||
| NPI: | 1194743914 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PENLEY | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 440100 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372440100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153290570 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2004 HAYES ST STE 350 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153123333 | ||||||||
| FaxNumber: | 6153207091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 16053 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 4206464 | 01 | AETNA | OTHER | 64794274 | 05 | KY | MEDICAID | 4093902 | 01 | BCBS OF TN | OTHER | P00182953 | 01 | RAILROAD MEDICARE | OTHER | 3018083 | 05 | TN | MEDICAID |