Healthcare Provider Details

I. General information

NPI: 1841438579
Provider Name (Legal Business Name): VOYTIK CENTER FOR ORTHOPEDIC CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 WALNUT GROVE CHURCH RD
DAYTON TN
37321
US

IV. Provider business mailing address

2700 WESTSIDE DR NW SUITE 301
CLEVELAND TN
37312-3699
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 TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO1133
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPAC1237
License Number StateTN

VIII. Authorized Official

Name: BEVERLY B HAUN
Title or Position: PRACTICE MANAGER
Credential: CPC, CMOM
Phone: 423-303-3560