Provider Demographics
NPI:1386112092
Name:CANCER TREATMENT SPECIALIST, PC
Entity type:Organization
Organization Name:CANCER TREATMENT SPECIALIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-887-1114
Mailing Address - Street 1:7500 E MCCORMICK PKWY LOT 32
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2912
Mailing Address - Country:US
Mailing Address - Phone:615-887-1114
Mailing Address - Fax:
Practice Address - Street 1:85 MAUI LANI PKWY
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2416
Practice Address - Country:US
Practice Address - Phone:808-442-5700
Practice Address - Fax:808-442-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty