Provider Demographics
NPI:1104166313
Name:VANDERBILT MAURY RADIATION ONCOLOGY, LLC
Entity type:Organization
Organization Name:VANDERBILT MAURY RADIATION ONCOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, BSRT(T)(CT)
Authorized Official - Phone:615-875-4455
Mailing Address - Street 1:1003 RESERVE BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174
Mailing Address - Country:US
Mailing Address - Phone:931-380-1194
Mailing Address - Fax:931-486-1373
Practice Address - Street 1:1003 RESERVE BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:931-380-1194
Practice Address - Fax:931-486-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation