Basic Information
| Provider Information | |||||||||
| NPI: | 1659981637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEVEN SPRINGS ORTHOPAEDICS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 317 SEVEN SPRINGS WAY STE 317 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370274575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153709992 | ||||||||
| FaxNumber: | 6153709665 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 BIBLE XING | ||||||||
| Address2: | |||||||||
| City: | DECHERD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373243886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153709992 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2020 | ||||||||
| LastUpdateDate: | 08/05/2020 | ||||||||
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| AuthorizedOfficialLastName: | TULLOCH | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153709992 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SEVEN SPRINGS ORTHOPAEDICS, PC | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 207XX0005X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.