Organization
MIDDLE TENNESSEE RADIATION ONCOLOGY SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURA L. CAMPBELL M.D. (PRESIDENT)
(615) 768-2855
Entity
Organization
Contact information
Practice address
300 STONECREST BLVD, STE 155, SMYRNA, TN 37167-5688
(615) 768-2855
(615) 768-2856
Mailing address
300 STONECREST BLVD, STE 155, SMYRNA, TN 37167-5688
(615) 768-2855
(615) 768-2856
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10082401
AMERIGROUP
TN
01
—
3715295
TNCARE
TN
01
—
TN0101
AMERICHOICE
TN
Enumeration date
08/20/2007
Last updated
11/20/2007
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