Healthcare Provider Details
I. General information
NPI: 1568853588
Provider Name (Legal Business Name): TENNESSEE ORTHOPAEDIC ALLIANCE, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2015
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
270 E MAIN ST STE 300
GALLATIN TN
37066-3067
US
IV. Provider business mailing address
PO BOX 306556
NASHVILLE TN
37230-6556
US
V. Phone/Fax
- Phone: 615-278-1673
- Fax: 615-278-1672
- Phone: 865-243-8153
- Fax: 615-695-1494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
MCSWAIN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 865-243-8183