Provider Demographics
NPI:1730371865
Name:LECONTE ORTHOPEDICS, PLLC
Entity type:Organization
Organization Name:LECONTE ORTHOPEDICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KELSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-643-2576
Mailing Address - Street 1:281 UNDERPASS DR
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-5885
Mailing Address - Country:US
Mailing Address - Phone:423-569-5454
Mailing Address - Fax:423-569-5858
Practice Address - Street 1:1108 FOX MEADOWS BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6939
Practice Address - Country:US
Practice Address - Phone:865-366-1581
Practice Address - Fax:865-366-1584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207Q00000X, 2081P2900X, 208VP0014X, 363A00000X, 363LF0000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100396980Medicaid
TNQ002467Medicaid
KY7100357840Medicaid
TNQ002467Medicaid
TN3708907Medicare PIN