Provider Demographics
NPI:1346359460
Name:GLATTES, RUDOLPH CHIRSTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:RUDOLPH
Middle Name:CHIRSTOPHER
Last Name:GLATTES
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 1:2021 CHURCH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-284-2000
Mailing Address - Fax:615-284-2003
Practice Address - Street 1:2021 CHURCH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-284-2000
Practice Address - Fax:615-284-2003
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35263207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208983700Medicaid
P00047432OtherRAILROAD MEDICARE
KS100454230AMedicaid
MO32353015OtherBCBS
KS519700OtherFIRSTGUARD
KS519700OtherFIRSTGUARD
UTH58858Medicare UPIN