Healthcare Provider Details

I. General information

NPI: 1659981637
Provider Name (Legal Business Name): SEVEN SPRINGS ORTHOPAEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 BIBLE XING
DECHERD TN
37324-3886
US

IV. Provider business mailing address

317 SEVEN SPRINGS WAY STE 317
BRENTWOOD TN
37027-4575
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-9992
  • Fax:
Mailing address:
  • Phone: 615-370-9992
  • Fax: 615-370-9665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARK TULLOCH
Title or Position: PRESIDENT
Credential:
Phone: 615-370-9992