Healthcare Provider Details

I. General information

NPI: 1851817290
Provider Name (Legal Business Name): TENNESSEE FOOT & ANKLE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 08/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 HIGHLAND TER STE B
MURFREESBORO TN
37130-2424
US

IV. Provider business mailing address

515 HIGHLAND TER STE B
MURFREESBORO TN
37130-2424
US

V. Phone/Fax

Practice location:
  • Phone: 615-890-6624
  • Fax: 615-849-9746
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: JAMES A SUDBERRY
Title or Position: OWNER
Credential: DMP
Phone: 615-712-7366