Organization
ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN LAWSON CPA (ADMINISTRATOR)
(615) 284-2000
Entity
Organization
Contact information
Practice address
5021 CAROTHERS PARKWAY, FRANKLIN, TN 37064
(615) 324-1600
Mailing address
2004 HAYES ST STE 200, NASHVILLE, TN 37203-2646
(615) 284-2000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3732025
GROUP MEDICARE NUMBER
TN
05
—
3732025
—
TN
Enumeration date
03/28/2013
Last updated
05/04/2022
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