Organization
ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Active
Parent organization
ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Authorized official
CLAUDIA LAGACY (OFFICE MANAGER)
(615) 342-0264
Entity
Organization
Contact information
Practice address
107 GLIDEPATH WAY, LEBANON, TN 37090-4133
(615) 324-1600
(615) 284-2003
Mailing address
PO BOX 896172, CHARLOTTE, NC 28289-6172
(615) 324-1600
(615) 284-2003
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
TN
207RC0000X
Cardiovascular Disease Physician
—
TN
207X00000X
Orthopaedic Surgery Physician
—
TN
207XS0106X
Orthopaedic Hand Surgery Physician
—
TN
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
TN
Other
Enumeration date
11/29/2016
Last updated
07/18/2017
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