Organization
FAMILY CANCER CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM K WALSH M.D. (MANAGING PHYSICIAN)
(901) 685-5655
Entity
Organization
Contact information
Practice address
391 SOUTHCREST CIR, SUITE 101, SOUTHAVEN, MS 38671-4848
(662) 349-0755
(662) 349-0356
Mailing address
P.O. BOX 5111, MEMPHIS, TN 38101-5111
(901) 685-5655
(901) 685-2590
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19652
TN
207RH0003X
Hematology & Oncology Physician
18137
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090015910
—
MS
05
—
090015910
—
MS
01
—
CK3826
RRMCR
MS
Enumeration date
07/31/2006
Last updated
03/09/2011
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