Provider Demographics
NPI:1043371016
Name:SOUTHERN TENNESSEE ORTHOPAEDIC & HAND SURGERY, PLLC
Entity Type:Organization
Organization Name:SOUTHERN TENNESSEE ORTHOPAEDIC & HAND SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-363-2123
Mailing Address - Street 1:1275 E COLLEGE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4500
Mailing Address - Country:US
Mailing Address - Phone:931-363-2123
Mailing Address - Fax:931-363-8123
Practice Address - Street 1:1275 E COLLEGE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4500
Practice Address - Country:US
Practice Address - Phone:931-363-2123
Practice Address - Fax:931-363-8123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD16256174400000X
TN5505880001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3726039Medicare ID - Type UnspecifiedGROUP NUMBER
TN5505880001Medicare NSC