Healthcare Provider Details

I. General information

NPI: 1235269879
Provider Name (Legal Business Name): SOUTHERN HILLS ORTHOPAEDIC CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 11/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 WALLACE RD SUITE 201
NASHVILLE TN
37211-4881
US

IV. Provider business mailing address

395 WALLACE RD SUITE 201
NASHVILLE TN
37211-4881
US

V. Phone/Fax

Practice location:
  • Phone: 615-781-1001
  • Fax: 615-781-1002
Mailing address:
  • Phone: 615-781-1001
  • Fax: 615-781-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHUCK LOCKE
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-373-7604