Provider Demographics
NPI:1528072030
Name:FAMILY CANCER CENTER, PLLC
Entity type:Organization
Organization Name:FAMILY CANCER CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:EARLE
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-850-0272
Mailing Address - Street 1:PO BOX 242173
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38124-2173
Mailing Address - Country:US
Mailing Address - Phone:901-850-0272
Mailing Address - Fax:
Practice Address - Street 1:271 W POLK AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4228
Practice Address - Country:US
Practice Address - Phone:731-287-8395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN020435174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1336147263OtherALBERT WEEKS-NPI
TN1548268592OtherSUHAIL OBAJI-NPI