Healthcare Provider Details

I. General information

NPI: 1740832823
Provider Name (Legal Business Name): TENNESSEE SPINE AND JOINT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5154 STAGE RD STE 101
MEMPHIS TN
38134-3118
US

IV. Provider business mailing address

2385 NW EXECUTIVE CENTER DR STE 150
BOCA RATON FL
33431-7371
US

V. Phone/Fax

Practice location:
  • Phone: 901-444-3001
  • Fax:
Mailing address:
  • Phone: 954-320-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL J HESS
Title or Position: OWNER
Credential: MD
Phone: 954-320-4600