Organization
ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN LAWSON CPA (ADMINISTRATOR)
(615) 284-2000
Entity
Organization
Contact information
Practice address
1616 W MAIN ST, SUITE 203, LEBANON, TN 37087-3100
(615) 284-2000
(615) 284-2003
Mailing address
2004 HAYES ST, SUITE 200, NASHVILLE, TN 37203-2646
(615) 284-2000
(615) 284-2003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3732025
GROUP MEDICARE NUMBER
TN
Enumeration date
03/10/2014
Last updated
01/08/2021
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