Provider Demographics
NPI:1174664296
Name:ELALAYLI, TAREK GALAL (MD)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:GALAL
Last Name:ELALAYLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2054
Practice Address - Country:US
Practice Address - Phone:615-885-0200
Practice Address - Fax:615-885-0267
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31631207XS0117X, 207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
201221325OtherTRICARE
TN3841844Medicaid
TN4343261OtherBCBS
TN4091928OtherBLUECROSS
TN5642616OtherCIGNA
KY64712987Medicaid
201221325OtherGREAT WEST HEALTHCARE
TN3841844OtherMEDICARE
TN201221325OtherHEALTHSPRING
TNQ000423Medicaid
TN7740006OtherAETNA
TN7740006OtherAETNA
201221325OtherTRICARE
TN103I202129Medicare UPIN