MID SOUTH RADIATION ONCOLOGY CENTER LLC NPI 1063415461

NPI Information

  • NPI: 1063415461
  • Provider Name: MID SOUTH RADIATION ONCOLOGY CENTER, LLC
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Organization
  • Address: 1381 S GERMANTOWN RD
    GERMANTOWN, TN
    ZIP 38138
  • Phone: (901) 624-2600

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NPI Details

MID SOUTH RADIATION ONCOLOGY CENTER, LLC is a radiation oncology radiology in Germantown, TN. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. MID SOUTH RADIATION ONCOLOGY CENTER, LLC NPI is 1063415461. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1381 S GERMANTOWN RD
GERMANTOWN, TN
ZIP 38138-225
Phone: (901) 624-2600

The provider's authorized official is Todd Stockstill .
The authorized official title is Chief Manager and has the following contact phone number (901) 624-2600.

The enumeration date for this NPI number is 5/31/2005 and was last updated on 7/21/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0001XRadiologyRadiation OncologyTENNESSEEYes

What is NPI?

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This page was last updated on: 3/30/2025

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