Whitehead, Mark A.

Whitehead, Mark A. is an individual health care provider with primary practice located at 1222 Trotwood Ave. Ste 108, Columbia TN 38401. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Whitehead, Mark A. can be contacted via phone (931) 388-8965.

Contact Information

Primary practice address
1222 Trotwood Ave. Ste 108 Columbia TN 38401
Phone: (931) 388-8965
Fax: (931) 840-8520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1531 Tennessee
Allopathic & Osteopathic Physicians / Pediatrics 208000000X PA0000001531 Tennessee

Profile Details

NPI number 1235326059
LBN Legal business name Whitehead, Mark A.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2007
Last updated Feb 13th, 2017 - about 7 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 1235326059 NPPES
Tennessee MEDICAID 1501347

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