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General NPI Number Information
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NPI Number | 1629311691
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Entity Type | Organization
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Legal Business Name | ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 5021 CAROTHERS PARKWAY
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City | FRANKLIN
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State | TN
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Zip | 37064
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Country | US
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Telephone | 615-324-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 HAYES ST STE 200
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City | NASHVILLE
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State | TN
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Zip | 37203-2646
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Country | US
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Telephone | 615-284-2000
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUSTIN LAWSON
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Credential | CPA
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Telephone | 615-284-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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