MEDICARE: CHAD T PRICE MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	42715	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	615068301	OTHER	TN	US DEPARTMENT OF LABOR
2	11777110	OTHER	TN	CAQH

General Provider Information

NPI Number	:	1740511401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAD T PRICE MD PC

Provider Business Mailing Address
First Line	:	PO BOX 725
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37088-0725
Country	:	US
Telephone Number	:	615-444-4406
Fax Number	:	615-449-3174

Provider Business Practice Location Address
First Line	:	1616 W MAIN ST
Second Line	:	SUITE 203
City	:	LEBANON
State	:	TN
Zip	:	37087-3100
Country	:	US
Telephone Number	:	615-444-4406
Fax Number	:	615-449-3174

Authorized Official
Title or Position	:	OWNER PHYSICIAN
Name	:	CHAD THOMAS PRICE
Credential	:	M.D.
Telephone Number	:	615-444-4406

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	09/13/2011

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Directions to “CHAD T PRICE MD PC ” Practice Location

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