Organization
SPORT ORTHO URGENT CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R. KAELIN JR. M.D. (OWNER)
(615) 553-5000
Entity
Organization
Contact information
Practice address
4998 CROSSINGS CIR STE 200, MOUNT JULIET, TN 37122-0018
(615) 553-5000
(615) 758-3875
Mailing address
4998 CROSSINGS CIR STE 200, MOUNT JULIET, TN 37122-0018
(615) 553-5000
(615) 758-3875
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q021469
—
TN
Enumeration date
05/21/2015
Last updated
07/15/2021
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