1740767805 NPI number — COMPASSIONATE ORTHOPEDIC CARE PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740767805 NPI number — COMPASSIONATE ORTHOPEDIC CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASSIONATE ORTHOPEDIC CARE PLLC
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:
1740767805
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8011 BROOKS CHAPEL RD STE 2552
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-3964
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-529-8821
Provider Business Mailing Address Fax Number:
615-915-4547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8011 BROOKS CHAPEL RD
Provider Second Line Business Practice Location Address:
STE 2552
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-3964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-529-8821
Provider Business Practice Location Address Fax Number:
615-915-4547
Provider Enumeration Date:
07/23/2018

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
WILLIAMS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
315-529-8821

Provider Taxonomy Codes

  • Taxonomy code: 163WW0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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