Healthcare Provider Details

I. General information

NPI: 1922127208
Provider Name (Legal Business Name): ROBERT C. BONE, M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WEST MAIN STREET
LEBANON TN
37087-1511
US

IV. Provider business mailing address

620 WEST MAIN STREET
LEBANON TN
37087-1511
US

V. Phone/Fax

Practice location:
  • Phone: 615-444-2400
  • Fax:
Mailing address:
  • Phone: 615-444-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ROBERT CARVER BONE
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 615-444-2400