Provider Demographics
NPI:1417597196
Name:SPINE AND ORTHOPEDIC SPECIALISTS OF TENNESSEE, PLLC
Entity Type:Organization
Organization Name:SPINE AND ORTHOPEDIC SPECIALISTS OF TENNESSEE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-507-0800
Mailing Address - Street 1:2002 RICHARD JONES RD STE C300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2867
Mailing Address - Country:US
Mailing Address - Phone:629-206-3210
Mailing Address - Fax:629-206-3207
Practice Address - Street 1:2002 RICHARD JONES RD STE C300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2867
Practice Address - Country:US
Practice Address - Phone:629-206-3210
Practice Address - Fax:629-206-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty