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Organization

TENNESSEE SPORTS MEDICINE & ORTHOPAEDICS, PC

Active
Other names
Tennessee Sports Medicine & Orthopaedics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES ROBERT KAELIN JR. M.D. (OWNER/MD)
(615) 443-7700
Entity
Organization

Contact information

Practice address
1427 W BADDOUR PKWY, SUITE A, LEBANON, TN 37087-2513
(615) 443-7700
(615) 443-7200
Mailing address
1427 W BADDOUR PKWY, SUITE A, LEBANON, TN 37087-2513
(615) 443-7700
(615) 443-7200

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3080388
TN
01
3723654
MEDICARE GROUP NUMBER
Enumeration date
10/18/2007
Last updated
03/20/2008
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