Head, Mark Edward

Head, Mark Edward is an individual health care provider with primary practice located at 301 Gordon Gutmann Blvd Ste 101 , Jeffersonville IN 47130-3765. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Head, Mark Edward can be contacted via phone (812) 282-4844.

Contact Information

Primary practice address
301 Gordon Gutmann Blvd Ste 101 Jeffersonville IN 47130-3765
Phone: (812) 282-4844
Fax: (812) 282-6248
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01052682A Indiana
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 01052682A Indiana

Profile Details

NPI number 1639172570
LBN Legal business name Head, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Feb 23rd, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639172570 NPPES
Kentucky MEDICAID 64026982
Kentucky MEDICAID 200262820
Kentucky Other 34228
Kentucky Other 01052682A

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