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FAMILY CANCER CENTER PLLC NPI 1407862899


NPI Information

NPI: 1407862899
Provider Name: FAMILY CANCER CENTER, PLLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
391 SOUTHCREST CIR
SUITE 101
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-0755
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FAMILY CANCER CENTER, PLLC is a specialist in Southaven, MS. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FAMILY CANCER CENTER, PLLC NPI is 1407862899. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

391 SOUTHCREST CIR
SUITE 101
SOUTHAVEN, MS
ZIP 38671-848
Phone: (662) 349-0755
Fax: (662) 349-0356

The provider's authorized official is William K Walsh .
The authorized official title is Managing Physician and has the following contact phone number (901) 685-5655.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 3/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology18137MISSISSIPPINo
2174400000XSpecialist19652TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CK3826OTHERMISSISSIPPIRRMCR
2090015910MEDICAIDMISSISSIPPI
3=========OTHERMISSISSIPPIBCBS
4=========OTHERTENNESSEETAX ID/EIN
50090015910MEDICAIDMISSISSIPPI
63913140009MEDICARE NSCMISSISSIPPI
7C02685MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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