Provider Demographics
NPI:1629549845
Name:DICKSON ORTHOPAEDIC AND SPORTS MEDICINE PLLC
Entity Type:Organization
Organization Name:DICKSON ORTHOPAEDIC AND SPORTS MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-740-0080
Mailing Address - Street 1:196 HILLVIEW ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1285
Mailing Address - Country:US
Mailing Address - Phone:615-740-0080
Mailing Address - Fax:615-467-8797
Practice Address - Street 1:1100 TED A CROZIER SR BLVD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8912
Practice Address - Country:US
Practice Address - Phone:931-802-8990
Practice Address - Fax:931-802-8565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1511190Medicaid