Individual
JONATHAN PHILIP CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 PHYSICIANS WAY, SUITE 110, LEBANON, TN 37090-8102
(615) 547-6700
(615) 547-6707
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
44463
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
44463
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513462
—
TN
Enumeration date
05/21/2007
Last updated
08/21/2020
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