Provider Demographics
NPI:1235269879
Name:SOUTHERN HILLS ORTHOPAEDIC CONSULTANTS LLC
Entity Type:Organization
Organization Name:SOUTHERN HILLS ORTHOPAEDIC CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7604
Mailing Address - Street 1:395 WALLACE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4881
Mailing Address - Country:US
Mailing Address - Phone:615-781-1001
Mailing Address - Fax:615-781-1002
Practice Address - Street 1:395 WALLACE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4881
Practice Address - Country:US
Practice Address - Phone:615-781-1001
Practice Address - Fax:615-781-1002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHSERV AQUISITION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370040Medicaid
TN3370040Medicare PIN