Healthcare Provider Details
I. General information
NPI: 1104815430
Provider Name (Legal Business Name): NASHVILLE BONE AND JOINT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2005
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 OLD LEBANON DIRT RD FL 2
HERMITAGE TN
37076-2386
US
IV. Provider business mailing address
302 OLD LEBANON DIRT RD STE 200
HERMITAGE TN
37076-2391
US
V. Phone/Fax
- Phone: 615-391-4545
- Fax: 615-391-4546
- Phone:
- Fax:
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:
WALTER
SCOTT
DUBE
Title or Position: OWNER
Credential: M.D.
Phone: 615-391-4545