Provider Demographics
NPI:1902184492
Name:CENTRAL TENNESSEE FOOT AND ANKLE CENTER LLC
Entity Type:Organization
Organization Name:CENTRAL TENNESSEE FOOT AND ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-815-1006
Mailing Address - Street 1:1589 SPARTA ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-1390
Mailing Address - Country:US
Mailing Address - Phone:931-815-1006
Mailing Address - Fax:931-815-1007
Practice Address - Street 1:1589 SPARTA ST
Practice Address - Street 2:SUITE 205
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1390
Practice Address - Country:US
Practice Address - Phone:931-815-1006
Practice Address - Fax:931-815-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty