Organization
FAMILY CANCER CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM K. WALSH M.D. (MANAGING PHYSICIAN)
(901) 685-5655
Entity
Organization
Contact information
Practice address
1012 S MILES AVE, UNION CITY, TN 38261
(731) 884-1412
(731) 884-1720
Mailing address
PO BOX 242173, MEMPHIS, TN 38124-2173
(901) 850-0272
(901) 850-0782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23524
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135396002
—
AR
05
—
3723894
—
TN
01
—
4035183
BCBS
TN
01
—
CG9522
RRMCR
TN
Enumeration date
07/29/2006
Last updated
07/23/2010
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