Basic Information
| Provider Information | |||||||||
| NPI: | 1164834057 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRISTAR JOINT REPLACEMENT INSTITUTE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 PATTERSON ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031562 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 2400 PATTERSON ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153420038 | ||||||||
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| ProviderEnumerationDate: | 05/27/2014 | ||||||||
| LastUpdateDate: | 10/08/2014 | ||||||||
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| AuthorizedOfficialLastName: | DUNCAN | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 6158864969 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.