Healthcare Provider Details
I. General information
NPI: 1174655252
Provider Name (Legal Business Name): TENNESSEE ORTHOPAEDIC ALLIANCE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2007
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
215 GOTHIC CT STE 101
FRANKLIN TN
37067-8314
US
IV. Provider business mailing address
PO BOX 9118
MINNEAPOLIS MN
55480-9118
US
V. Phone/Fax
- Phone: 615-236-5000
- Fax: 615-236-5005
- Phone: 615-329-2294
- Fax: 615-695-1494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
MCSWAIN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 865-243-8183