MARK WATHEN


Address: 228 W 4th St, Suite 200, Cookeville, TN 38501-2488
Phone: 9313720405

MARK WATHEN (NPI# 1104925536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104925536
Entity Type Individual
Full Name MARK WATHEN
Credential MD
Practice Address 228 W 4th St
Suite 200
Cookeville
TN 38501-2488
Practice Telephone 9313720405
Practice Fax Number 9313720463
Mailing Telephone 9313720405
Mailing Fax Number 9313720463
Enumeration Date 2006-09-22
Last Update Date 2019-03-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 23921 TN Allopathic & Osteopathic Physicians
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
23921 TN Allopathic & Osteopathic Physicians
Y 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
23921 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN 1509597 05
TN BCBS 4288686 01

Office Location

Street Address 228 W 4TH ST
SUITE 200
City COOKEVILLE
State TN
Zip Code 38501-2488

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982605382 Jennifer L Mabry Registered Nurse 228 W 4th St, Ste 200, Cookeville, TN 38501-2488 2005-08-09
1679904494 Karli Qualls Physician Assistant 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 2013-12-04
1043652738 Angeli B Swallows Nurse Practitioner 228 W 4th St, Suite 301, Cookeville, TN 38501-2488 2013-07-23
1841497203 Brian R Dulin Internal Medicine 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 2007-06-29
1083743413 Brian Keith Dockery Internal Medicine 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 2007-03-02
1588733877 Tennessee Heart Pllc Specialist 228 W 4th St, Suite 200, Cookeville, TN 38501-2489 2006-11-08
1265480867 Steven Bickel Physician Assistant 228 W 4th St, Suite 301, Cookeville, TN 38501-2488 2006-05-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1811596711 Results-ast Jv, LLC Physical Therapist 627 James Campbell Blvd, South, Suite B, Columbia, TN 38501 2020-10-21
1376167080 Melinda Jane Jetter Registered Nurse 320 North Willow Avenue, Cookeville, TN 38501 2020-05-29
1366950875 Tara Beth Smith Occupational Therapist 315 N Washington Ave Ste 240, Cookeville, TN 38501 2018-01-18
1669990339 Tonya Rachelle Perry Counselor 13 South Jefferson Ave, Cookeville, TN 38501 2017-09-01
1659896207 Dustin Chase Rich Physical Therapist 105 S. Willow Ave, #100, Cookeville, TN 38501 2017-08-04
1487009668 Holly Young Physical Therapist 315 North Washungton Ave., Suite 240, Cookeville, TN 38501 2016-04-26
1194190306 Johnna Sprague Nurse Practitioner 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 2015-12-14
1881099885 Carlos Alberto Podesta Internal Medicine 238 W 4th St Ste 200, Cookeville, TN 38501 2014-11-03
1124445002 Shashank Sarvepalli Internal Medicine 1 Medical Center Blvd Ste D, Cookeville, TN 38501 2014-03-27
1689095762 Kendra Hicks Licensed Practical Nurse 701 County Services Drive, Cookeville, TN 38501 2013-12-17
Find all providers in zip 38501

Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861015935 Basu Ray Cardiology Associates PC Internal Medicine 1755 Groveway Dr, Germantown, TN 38139-5554 2020-05-25
1538391446 Indranill Basu Ray Internal Medicine 6005 Park Ave Ste 500b, Memphis, TN 38119 2009-08-12
1548266786 Tibor Sandor Szabo Internal Medicine 7460 Wolf River Blvd, Germantown, TN 38138-1760 2005-06-22
1275811713 Knoxville Hma Cardiology Ppm, LLC Internal Medicine 1225 E Weisgarber Rd, Knoxville, TN 37909-2604 2011-08-02
1518279686 Chattanooga Hamilton County Hospital Authority Internal Medicine 979 E 3rd St, Suite C-520, Chattanooga, TN 37403-2136 2010-07-06
1174842181 Specialty Physician Group LLC Internal Medicine 7460 Wolf River Blvd, Germantown, TN 38138-1760 2010-06-01
1831332626 Karine Guerrier Internal Medicine 848 Adams Ave, Ste. L400, Memphis, TN 38103 2009-04-09
1518122613 Martin Antonio Espinosa Internal Medicine 222 22nd Ave N, Suite 400, Nashville, TN 37203-1852 2008-07-28
1093978751 Rashmi Ujaneppa Hottigoudar Internal Medicine 7557b Dannaher Dr Ste 225, Powell, TN 37849-3568 2008-07-02
1265606255 Przemyslaw Peter Borek Internal Medicine 2400 Patterson St Ste 502, Nashville, TN 37203-6511 2008-04-22
Find all providers with the same taxonomy

Competitor

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City COOKEVILLE
Zip Code 38501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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