National Provider Identifier Database

FAMILY CANCER CENTER PLLC
Specialist

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.


Contact Information

FAMILY CANCER CENTER, PLLC
391 SOUTHCREST CIR
SUITE 101
SOUTHAVEN, MS38671-4848
Phone: 662-349-0755
Fax: 662-349-0356
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Hematology & Oncology 207RH0003X

* Indicates primary specialty

NPI Profile & details for FAMILY CANCER CENTER, PLLC

NPI Number 1407862899
Legal business name
LBN
FAMILY CANCER CENTER, PLLC
Authorized official WILLIAM WALSH - (MANAGING PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 07/31/2006
Last updated 03/09/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: 18137
  • TN License #: 19652
  • MS Medicaid: 0090015910
  • MS Medicaid: 090015910
  • MS Other: CK3826 RRMCR

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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