1639570369 NPI number — SEVEN SPRINGS ORTHOPAEDICS AND SPORTS MEDICINE

Table of content: (NPI 1639570369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639570369 NPI number — SEVEN SPRINGS ORTHOPAEDICS AND SPORTS MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEVEN SPRINGS ORTHOPAEDICS AND SPORTS MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639570369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
317 SEVEN SPRINGS WAY
Provider Second Line Business Mailing Address:
STE 101
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4575
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-370-9992
Provider Business Mailing Address Fax Number:
615-370-9665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1405 HILLSBORO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37355-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-954-1020
Provider Business Practice Location Address Fax Number:
931-954-1024
Provider Enumeration Date:
09/12/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BELL
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
B
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-370-9992

Provider Taxonomy Codes

  • Taxonomy code: 207XX0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)