Provider Demographics
NPI:1326030156
Name:TENNESSEE ORTHOPEDICS, P.C.
Entity Type:Organization
Organization Name:TENNESSEE ORTHOPEDICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-449-0990
Mailing Address - Street 1:1420 W BADDOUR PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1510
Mailing Address - Country:US
Mailing Address - Phone:615-449-0990
Mailing Address - Fax:615-444-1924
Practice Address - Street 1:1420 W BADDOUR PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1510
Practice Address - Country:US
Practice Address - Phone:615-449-0990
Practice Address - Fax:615-444-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3717761Medicaid
TN5241030001Medicare NSC
TN3717761Medicaid