Healthcare Provider Details

I. General information

NPI: 1235552381
Provider Name (Legal Business Name): LECONTE ORTHOPEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 FOX MEADOWS BLVD STE 1
SEVIERVILLE TN
37862-6939
US

IV. Provider business mailing address

1108 FOX MEADOWS BLVD STE 1
SEVIERVILLE TN
37862-6939
US

V. Phone/Fax

Practice location:
  • Phone: 865-366-1581
  • Fax: 865-366-1584
Mailing address:
  • Phone: 865-366-1581
  • Fax: 865-366-1584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD15308
License Number StateTN

VIII. Authorized Official

Name: DOUGLAS J ESTEY
Title or Position: MANAGING MEMBER
Credential: PA-C
Phone: 865-366-1581