Provider Demographics
NPI:1336285535
Name:BONE & JOINT SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:BONE & JOINT SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-644-0474
Mailing Address - Street 1:1004 CORNERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5847
Mailing Address - Country:US
Mailing Address - Phone:731-644-0474
Mailing Address - Fax:731-644-1892
Practice Address - Street 1:1004 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5847
Practice Address - Country:US
Practice Address - Phone:731-644-0474
Practice Address - Fax:731-644-1892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3724215Medicaid
TN3724215Medicaid