FAMILY CANCER CENTER, PLLC (NPI# 1790790715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790790715 |
| Entity Type | Organization |
| Organization Name | FAMILY CANCER CENTER, PLLC |
| Practice Address |
440 Wilkinson Dr Dyersburg TN 38024-2085 |
| Mailing Address |
P.o. Box 5111 Memphis TN 38101-5111 |
| Practice Telephone | 9013790703 |
| Practice Fax Number | 9013790532 |
| Mailing Telephone | 9016855655 |
| Mailing Fax Number | 9016852590 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2011-03-09 |
| Authorized Official Name | WILLIAM K WALKSH (MANAGING PHYSICIAN) |
| Authorized Official Telephone | 9016855655 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 015925 | TN | Other Service Providers |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD0000015925 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 135396002 | 05 | |
| TN | 3723894 | 05 | |
| TN | BCBS | 4035183 | 01 |
| TN | RRMCR | CG9522 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215943675 | Family Cancer Center, Pllc | Internal Medicine | 6029 Walnut Grove, Suite 301, Memphis, TN 38120-2112 | 2006-07-31 |
| 1518972462 | Family Cancer Center, Pllc | Specialist | 1350 Sunset Dr, Suite B, Grenada, MS 38901-4079 | 2006-07-29 |
| 1528072030 | Family Cancer Center, Pllc | Specialist | 271 W Polk Ave, West Memphis, AR 72301-4228 | 2006-07-28 |
| 1912911611 | Family Cancer Center, Pllc | Internal Medicine | 2996 Kate Bond, Suite 207, Bartlett, TN 38133-4062 | 2006-07-28 |
| 1275551012 | Family Cancer Center, Pllc | Internal Medicine | 1936 W. Poplar Ave, Collierville, TN 38017-0605 | 2006-07-18 |
| 1013211416 | Family Cancer Center, Pllc | Internal Medicine | 6005 Park Ave, 1000-b, Memphis, TN 38119-5202 | 2010-12-29 |
| 1407862899 | Family Cancer Center, Pllc | Internal Medicine | 391 Southcrest Cir, Suite 101, Southaven, MS 38671-4848 | 2006-07-31 |
| 1316951627 | Family Cancer Center, Pllc | Internal Medicine | 504 Azalea Dr, Suite A, Oxford, MS 38655-5397 | 2006-07-29 |
| 1437163383 | Family Cancer Center, Pllc | Specialist | 6005 Park Ave, Suite 1000-b, Memphis, TN 38119-5225 | 2006-07-28 |
| Street Address |
440 WILKINSON DR |
| City | DYERSBURG |
| State | TN |
| Zip Code | 38024-2085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760273 | Alison Clement | Nurse Practitioner | 750 W Highway 51 Bypass, Dyersburg, TN 38024 | 2020-01-29 |
| 1861030652 | Pagela Jobe | Nurse Practitioner | 750 West Highway 51 Bypass, Dyersburg, TN 38024 | 2019-12-12 |
| 1083184055 | Whitney Young | Nurse Practitioner | 455 East Parkview, Dyersburg, TN 38024 | 2018-12-03 |
| 1518434067 | Myeyedr Optometry of Tennessee, LLC | Optometrist | 400 Us Hwy 51 S, Dyersburg, TN 38024 | 2018-11-01 |
| 1225529142 | Kidney Experts Pllc | Internal Medicine | 1575 Parr Ave # B, Dyersburg, TN 38024 | 2018-05-25 |
| 1407344690 | Darnisha Williams | Pharmacist | 2650 Lake Road, Dyersburg, TN 38024 | 2018-04-24 |
| 1376081547 | Chasidy Branch | Counselor | 640 U.S. Highway 51 Bypass E. Suite M, Dyersburg, TN 38024 | 2017-02-07 |
| 1548671845 | Shree Ramakant Mulay | Internal Medicine | 1575 Parr Ave Ste B, Dyersburg, TN 38024 | 2014-05-08 |
| 1588904965 | Selina Carol Purvis | Physical Therapy Assistant | 1900 Parr Avenue, Dyersburg, TN 38024 | 2013-02-22 |
| 1326396029 | Tennessee Sleep Managment LLC | Clinic/Center | 1190 Hwy 51 By-pass West, Suite C, Dyersburg, TN 38024 | 2012-08-28 |
| Find all providers in zip 38024 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336779974 | Verdi Oncology Tennessee, PC | Internal Medicine | 2004 Hayes St Ste 720, Nashville, TN 37203-2658 | 2020-01-23 |
| 1841844099 | Tennessee Cancer Specialists Pllc | Internal Medicine | 7650 Dannaher Dr Ste 100, Powell, TN 37849-4052 | 2019-07-26 |
| 1710406350 | Hope, Blood and Cancer Center | Internal Medicine | 110 Corporate Dr Ste 120, Johnson City, TN 37604-2008 | 2017-09-14 |
| 1407201882 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 6408 Papermill Drive, Suite 220, Knoxville, TN 37919-4858 | 2016-05-04 |
| 1790192565 | Yonette Paul | Internal Medicine | 2202 N John B Dennis Hwy Ste 100, Kingsport, TN 37660-5904 | 2014-07-14 |
| 1942572862 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 2305 Chambliss Ave, Sw, Sky Ridge Medical Center Main, Cleveland, TN 37311-3899 | 2012-02-08 |
| 1619263852 | Namratha Reddy Vontela | Internal Medicine | 200 New York Ave Ste 200, Oak Ridge, TN 37830 | 2011-06-27 |
| 1356632624 | James Michael Pauff | Internal Medicine | 4488 Carothers Pkwy Ste 200, Franklin, TN 37067-6582 | 2011-04-21 |
| 1366740425 | Richert Edgar Goyette | Internal Medicine | 1706 Alcott Manor Ln, Knoxville, TN 37922-8094 | 2011-03-14 |
| 1649406687 | H2u Wellness Centers, LLC | Internal Medicine | 3322 West End Ave, Nashville, TN 37203 | 2009-06-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.