Provider Demographics
NPI:1215116231
Name:VOYTIK CENTER FOR ORTHOPEDIC CARE, PC
Entity type:Organization
Organization Name:VOYTIK CENTER FOR ORTHOPEDIC CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:GROOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-303-3561
Mailing Address - Street 1:3913 GEORGETOWN RD NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1806
Mailing Address - Country:US
Mailing Address - Phone:423-479-3600
Mailing Address - Fax:423-303-1234
Practice Address - Street 1:3913 GEORGETOWN RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-1806
Practice Address - Country:US
Practice Address - Phone:423-479-3600
Practice Address - Fax:423-303-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1133207X00000X
TNPAC0000001237363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504877Medicaid
TNP00669511OtherRAILROAD MEDICARE
TN1504877Medicaid
TN6560680001Medicare NSC