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General NPI Number Information
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NPI Number | 1821263245
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Entity Type | Organization
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Legal Business Name | TENNESSEE FOOT & ANKLE SURGEONS INC
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Dates
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Enumeration Date | 04/26/2008
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 320 S MAIN ST
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City | CROSSVILLE
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State | TN
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Zip | 38555-4838
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Country | US
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Telephone | 931-787-1170
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Fax | 931-787-1370
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Provider Business Mailing Address
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Address Line | 320 S MAIN ST
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City | CROSSVILLE
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State | TN
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Zip | 38555-4838
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Country | US
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Telephone | 931-787-1170
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Fax | 931-787-1370
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID E HAVERLY
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Credential | DPM
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Telephone | 931-787-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM379
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License Number State | TN
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