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Organization

BOSTON BASKIN CANCER FOUNDATION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS W RATLIFF MD (PRESIDENT)
(901) 767-4520
Entity
Organization

Contact information

Practice address
80 HUMPHREYS CENTER DR STE 330, MEMPHIS, TN 38120-2363
(901) 752-6131
(901) 752-6167
Mailing address
PO BOX 405827, ATLANTA, GA 30384-9446
(901) 227-8591

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
31689
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1526936
TN
05
2871745
MS
01
DS2781
RR MEDICARE TN
TN
01
DS2782
RR MEDICARE MS
MS
01
DS5687
MEDICARE RR AR
AR
Enumeration date
10/05/2011
Last updated
03/03/2016
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