MTN Orthoxpress Holdings, LLC

Organization Active NPI Sports Medicine (Orthopaedic Surgery) Physician · Atoka, TN

NPI 1376279463 · NPPES record last updated Jun 10, 2024

Key facts

NPI
1376279463
Entity type
Organization (NPI type 2)
Primary specialty
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
Legal business name
MTN ORTHOXPRESS HOLDINGS, LLC
Practice address
11645 Highway 51 S Ste 103
Atoka, TN 38004-2001
Phone
(901) 407-2221
Fax
(901) 407-2300
NPI assigned
Jul 29, 2022
Organization subpart
No

Authorized official

Name
Jennifer C Bullock
Title
President
Phone
(662) 534-2227

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207XX0005X Yes
Medical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363AM0700X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

11645 Highway 51 S Ste 103
Atoka, TN 38004-2001

Mailing address

206 Oxford Rd
New Albany, MS 38652-3115
Phone (662) 534-2227

Other practice location 1

6515 Poplar Ave Ste 106
Memphis, TN 38119-4878
Phone (901) 426-1090

Other providers in Atoka, TN

All providers in Atoka, TN · Sports Medicine (Orthopaedic Surgery) Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.