Healthcare Provider Details

I. General information

NPI: 1649271206
Provider Name (Legal Business Name): ROY C. TERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2005
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 Number25540
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: