Provider Demographics
NPI:1275573909
Name:BATTLEFIELD ORTHOPEDICS PC
Entity Type:Organization
Organization Name:BATTLEFIELD ORTHOPEDICS PC
Other - Org Name:THE ORTHOPEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRACY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-826-8585
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-0430
Mailing Address - Country:US
Mailing Address - Phone:423-648-9808
Mailing Address - Fax:423-648-4570
Practice Address - Street 1:7011 SHALLOWFORD RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6727
Practice Address - Country:US
Practice Address - Phone:423-826-8585
Practice Address - Fax:423-826-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3710034Medicare ID - Type Unspecified