Provider Demographics
NPI:1538364385
Name:KIMSEY RADIATION ONCOLOGY
Entity type:Organization
Organization Name:KIMSEY RADIATION ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-756-5329
Mailing Address - Street 1:605 GLENWOOD DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1108
Mailing Address - Country:US
Mailing Address - Phone:423-495-7736
Mailing Address - Fax:423-495-7718
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 208
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-495-7736
Practice Address - Fax:423-495-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000207752085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718137Medicaid
TN4064174OtherBLUECROSS
TNF83023Medicare UPIN
TN3718137Medicaid