Organization
TENN SM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN O'CONNOR (AUTHORIZED OFFICIAL)
(615) 376-7315
Entity
Organization
Contact information
Practice address
5002 CROSSINGS CIR, STE 110, MOUNT JULIET, TN 37122-8471
(615) 553-9100
(615) 553-9109
Mailing address
5002 CROSSINGS CIR, STE 110, MOUNT JULIET, TN 37122-8471
(615) 553-9100
(615) 553-9109
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
00000000199
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC6548
RAILROAD MCR
TN
Enumeration date
07/29/2008
Last updated
09/06/2024
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