Healthcare Provider Details

I. General information

NPI: 1801084884
Provider Name (Legal Business Name): TENNESSEE VALLEY BONE AND JOINT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N OCOEE ST
CLEVELAND TN
37311-3850
US

IV. Provider business mailing address

2350 N OCOEE ST
CLEVELAND TN
37311-3850
US

V. Phone/Fax

Practice location:
  • Phone: 423-476-5554
  • Fax:
Mailing address:
  • Phone: 423-476-5554
  • Fax: 423-614-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICKEY L HUTCHESON
Title or Position: OWNER
Credential: MD
Phone: 423-476-5554