Provider Demographics
NPI:1902267487
Name:JOHN C WESTERKAMM MD PLLC
Entity Type:Organization
Organization Name:JOHN C WESTERKAMM MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:COLEMAN
Authorized Official - Last Name:WESTERKAMM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-433-7302
Mailing Address - Street 1:451 NORTHCREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3973
Mailing Address - Country:US
Mailing Address - Phone:615-433-7302
Mailing Address - Fax:615-433-7303
Practice Address - Street 1:661 DUNBAR CAVE RD STE 102
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6572
Practice Address - Country:US
Practice Address - Phone:931-266-0808
Practice Address - Fax:615-433-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44369207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty