Family Cancer Center, PLLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

MD0000015925 Issued in TN

Legal business name

FAMILY CANCER CENTER, PLLC

Practice address

440 Wilkinson Dr
Dyersburg, TN 38024-2085

Phone

(901) 379-0703

Fax

(901) 379-0532

NPI assigned

Jul 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William K Walksh, M.D.

Title

Managing Physician

Phone

(901) 685-5655

Specialties & licenses 2

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1790790715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5111",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381015111",
            "telephone_number": "901-685-5655",
            "fax_number": "901-685-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WILKINSON DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242085",
            "telephone_number": "901-379-0703",
            "fax_number": "901-379-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CANCER CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "WALKSH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "901-685-5655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "015925",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "MD0000015925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135396002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723894",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "CG9522",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4035183",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hematology & Oncology Physician in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Hematology & Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.