Organization
TENNESSEE SPORTS MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ROBERT KAELIN (OWNER)
(615) 758-1010
Entity
Organization
Contact information
Practice address
799 S WILLOW AVE, COOKEVILLE, TN 38501-5997
(615) 553-5000
Mailing address
1286 OAK GROVE RD STE 100, BIRMINGHAM, AL 35209-6955
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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