Organization
SPECIALTY ORTHOPEDIC GROUP TENNESSEE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU CASSIDY FNP-C (BUSINESS OWNER)
(615) 237-5410
Entity
Organization
Contact information
Practice address
602 RED BOILING SPRINGS RD STE 106, LAFAYETTE, TN 37083-1316
(615) 237-5410
(615) 237-5411
Mailing address
PO BOX 81, CASTALIAN SPRINGS, TN 37031-0081
(615) 237-5431
(615) 237-5411
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000435
—
TN
Enumeration date
12/10/2019
Last updated
04/07/2025
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