Healthcare Provider Details

I. General information

NPI: 1134670664
Provider Name (Legal Business Name): TENNESSEE ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 HARTSVILLE PIKE
GALLATIN TN
37066-2491
US

IV. Provider business mailing address

556 HARTSVILLE PIKE
GALLATIN TN
37066-2491
US

V. Phone/Fax

Practice location:
  • Phone: 615-461-7335
  • Fax: 615-461-7418
Mailing address:
  • Phone: 615-461-7335
  • Fax: 615-461-7418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number StateTN

VIII. Authorized Official

Name: ROY C. TERRY
Title or Position: OWNER/DIRECTOR/MD
Credential: MD
Phone: 615-449-0990