Individual
MR. TERRANCE R HARTSOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 956-0650
Mailing address
PO BOX 1226, FRANKLIN, TN 37065-1226
(615) 591-2732
(615) 591-2779
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
716
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104956028
UNITED HEALTHCARE
TN
05
—
36669332
—
TN
01
—
4166977
BC/BS TN - CUMBERLAND BACK PAIN CLINIC, P.C.
TN
01
—
PA716
STATE LICENSE
TN
Enumeration date
03/07/2007
Last updated
05/29/2025
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