Organization
MID-SOUTH CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALYA KUSHNIR (BUSINESS OFFICE ASSISTANT MANAGER)
(901) 763-0446
Entity
Organization
Contact information
Practice address
8000 WOLF RIVER BLVD, SUITE 100, GERMANTOWN, TN 38138-1727
(901) 763-0446
(901) 763-0042
Mailing address
PO BOX 1000, DPT 242, MEMPHIS, TN 38148-0242
(901) 763-0446
(901) 763-0042
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06508079
—
MS
05
—
08051843
—
MS
05
—
149557
—
TN
01
—
4078501
BCBS
TN
01
—
5F008
BC OF AR
AR
Enumeration date
07/28/2005
Last updated
08/22/2020
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