Wathen, Mark

Wathen, Mark is an individual health care provider with primary practice located at 228 W 4Th St Suite 200, Cookeville TN 38501-2488. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Wathen, Mark can be contacted via phone (931) 372-0405.

Contact Information

Primary practice address
228 W 4Th St Suite 200 Cookeville TN 38501-2488
Phone: (931) 372-0405
Fax: (931) 372-0463
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 23921 Tennessee
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 23921 Tennessee
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 23921 Tennessee

Profile Details

NPI number 1104925536
LBN Legal business name Wathen, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Jun 17th, 2022 - about 3 years 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 1104925536 NPPES
Tennessee Other 4288686 BCBS
Tennessee MEDICAID 1509597 BCBS

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