Healthcare Provider Details

I. General information

NPI: 1598200248
Provider Name (Legal Business Name): HARDY ODELL ARROWOOD III MPAS, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 FRANK MARTIN RD STE 200
SHELBYVILLE TN
37160-7195
US

IV. Provider business mailing address

3143 BRIARWOOD DR
MURFREESBORO TN
37130-6836
US

V. Phone/Fax

Practice location:
  • Phone: 931-488-8700
  • Fax: 931-735-6456
Mailing address:
  • Phone: 615-347-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1993
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: