Provider Demographics
NPI:1891748885
Name:GRACE, SEAN PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:GRACE
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:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-695-1494
Practice Address - Street 1:988 OAK RIDGE TPKE STE 100
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6919
Practice Address - Country:US
Practice Address - Phone:865-483-8478
Practice Address - Fax:865-483-4194
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42255207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000530Medicaid
TN0677340005Medicare NSC
3000530Medicare PIN