Healthcare Provider Details

I. General information

NPI: 1326030156
Provider Name (Legal Business Name): TENNESSEE ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W BADDOUR PKWY STE 100
LEBANON TN
37087-1510
US

IV. Provider business mailing address

1420 W BADDOUR PKWY STE 100
LEBANON TN
37087-1510
US

V. Phone/Fax

Practice location:
  • Phone: 615-257-0190
  • Fax: 615-470-8038
Mailing address:
  • Phone: 615-257-0190
  • Fax: 615-470-8038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateTN

VIII. Authorized Official

Name: ROY TERRY
Title or Position: OWNER/MD
Credential: MD
Phone: 615-257-0190