Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 021350 | TN |
NPI | 1144205519 |
---|---|
Provider Name | Dr. Pat W Whitworth JR. |
First Address | Goodlettsville, TN 37072-3132 |
Second Address | Nashville, TN 37203-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 15/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2615200 | CIGNA (01) | |
3061640 | (05) | TN |
3061644 | (05) | TN |
3162056 | BLUE CROSS BLUE SHIELD (01) | TN |
4207493 | AETNA (01) | |
6026312 | BCBS (01) | TN |
C71197 | (02) | TN |
C71197 | HEALTHSPRING (01) | TN |