Healthcare Provider Details

I. General information

NPI: 1790336147
Provider Name (Legal Business Name): SEVEN SPRINGS ORTHOPAEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 HIGHWAY 76
WHITE HOUSE TN
37188
US

IV. Provider business mailing address

317 SEVEN SPRINGS WAY STE 101
BRENTWOOD TN
37027-4576
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-9992
  • Fax: 615-370-9665
Mailing address:
  • Phone: 615-370-9992
  • Fax: 615-370-9665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARK TULLOCH
Title or Position: CEO
Credential:
Phone: 159-473-3386