Healthcare Provider Details

I. General information

NPI: 1215116231
Provider Name (Legal Business Name): VOYTIK CENTER FOR ORTHOPEDIC CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 09/15/2023
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3913 GEORGETOWN RD NW
CLEVELAND TN
37312-1806
US

IV. Provider business mailing address

3913 GEORGETOWN RD NW
CLEVELAND TN
37312-1806
US

V. Phone/Fax

Practice location:
  • Phone: 423-479-3600
  • Fax: 423-303-1234
Mailing address:
  • Phone: 423-479-3600
  • Fax: 423-303-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPAC0000001237
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO1133
License Number StateTN

VIII. Authorized Official

Name: SUMMER GROOMES
Title or Position: PRACTICE MANAGER
Credential:
Phone: 423-303-3561