MR. FRANK GLOVER WITHERSPOON JR. (NPI# 1558338376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558338376 |
Entity Type | Individual |
Full Name | MR. FRANK GLOVER WITHERSPOON JR. |
Credential | MD |
Practice Address |
1455 Union Ave Memphis TN 38104-6727 |
Practice Telephone | 9017266655 |
Practice Fax Number | 9017269056 |
Mailing Telephone | 9017266655 |
Mailing Fax Number | 9017269056 |
Enumeration Date | 2006-03-01 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD11469 | TN | Allopathic & Osteopathic Physicians |
X | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD11469 | TN | Allopathic & Osteopathic Physicians |
X | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD11469 | TN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TN | 3190092 | 05 |
Street Address |
1455 UNION AVE |
City | MEMPHIS |
State | TN |
Zip Code | 38104-6727 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275506404 | Rex Allen Amonette | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-08 |
1356836076 | Mary Elizabeth Stephens | Nurse Practitioner | 1455 Union Ave, Memphis, TN 38104-6727 | 2018-06-25 |
1679937999 | Alexandra Dee Maxted Chantara | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2016-04-12 |
1376800979 | Joseph Pietrangelo | Dermatology | 1455 Union Ave, Memphis Dermatology Clinic, Memphis, TN 38104-6727 | 2012-04-19 |
1073824561 | Emily T. Overholser | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2010-06-29 |
1992927214 | Frances Kirkland Lawhead | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2007-05-03 |
1134346430 | Courtney Stroupe Woodmansee | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2007-04-19 |
1215904602 | Amy A Huber | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-03-03 |
1366416653 | Memphis Dermatology Clinic Pa | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-14 |
1669445276 | John Harvey Gardner | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
Find all providers in zip 38104 |
Taxonomy Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770550659 | Frances Beard | Dermatology | 1455 Union Avenue, Memphis, TN 38104-6727 | 2006-03-01 |
1275506404 | Rex Allen Amonette | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-08 |
1760459069 | John D Huber IIi | Dermatology | 1455 Union Avenue, Memphis, TN 38104-6727 | 2006-03-06 |
1215904602 | Amy A Huber | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-03-03 |
1700853520 | Robin H Friedman-musicante | Dermatology | 1455 Union Avenue, Memphis, TN 38104-6727 | 2006-03-01 |
1235106055 | Lee Allen | Dermatology | 1455 Union Avenue, Memphis, TN 38104-6727 | 2006-03-01 |
1669445276 | John Harvey Gardner | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295824415 | Tricities Skin and Cancer | Dermatology | 1009 N State of Franklin Access Road Suite A, Johnson City, TN 37604 | 2006-10-12 |
1457448599 | Brent Moody | Dermatology | 1900 Patterson St Ste 201, Nashville, TN 37203 | 2006-10-09 |
1942238902 | East Tennessee Medical Group, PC | Dermatology | 266 Joule Street, Alcoa, TN 37701-2422 | 2006-06-29 |
1881658243 | Adult & Pediatric Dermatology of Tullahoma PC | Dermatology | 100 William Northern Blvd, Ste C, Tullahoma, TN 37388 | 2006-04-13 |
1851369391 | Thomas Paul Chu | Dermatology | 520 Trinity Creek Cv, Cordova, TN 38018-2279 | 2006-03-10 |
1184608416 | Julie M Pena | Dermatology | 200 Cool Springs Blvd, Franklin, TN 37067-2677 | 2005-11-30 |
1306849500 | Steve Leroy Peterson | Dermatology | 1009 North State of Franklin Access Road, Johnson City, TN 37604 | 2005-05-23 |
1255938502 | Uderm, Pllc | Dermatology | 5243 Little Debbie Pkwy Ste 111, Ooltewah, TN 37363-4515 | 2020-10-08 |
1801362231 | Innova Dermatology PC | Dermatology | 105 Maple Row Blvd, Hendersonville, TN 37075-3853 | 2018-10-24 |
1669815452 | James Griffith | Dermatology | 201 Bluebird Dr, Goodlettsville, TN 37072-2301 | 2013-04-10 |
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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.