Organization
PETTY ORTHOPAEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAMON H PETTY MD (OWNER)
(615) 443-7374
Entity
Organization
Contact information
Practice address
1616 W. MAIN ST., SUITE 300, LEBANON, TN 37087
(615) 443-7374
(615) 443-5488
Mailing address
1616 W MAIN ST STE 300, LEBANON, TN 37087-3101
(615) 443-7374
(615) 443-5488
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861452195
MEDICARE NPI
TN
01
—
3732245
MEDICARE PTAN
TN
05
—
3732245
—
TN
Enumeration date
03/20/2006
Last updated
09/05/2012
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