Basic Information
| Provider Information | |||||||||
| NPI: | 1346359460 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLATTES | ||||||||
| FirstName: | RUDOLPH | ||||||||
| MiddleName: | CHIRSTOPHER | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 CHURCH STREET | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152842000 | ||||||||
| FaxNumber: | 6152842003 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 CHURCH STREET | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152842000 | ||||||||
| FaxNumber: | 6152842003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 35263 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | 35263 | TN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
ID Information
| ID | Type | State | Issuer | Description | 208983700 | 05 | MO | MEDICAID | P00047432 | 01 | RAILROAD MEDICARE | OTHER | 100454230A | 05 | KS | MEDICAID | 32353015 | 01 | MO | BCBS | OTHER | 519700 | 01 | KS | FIRSTGUARD | OTHER |