Provider Demographics
NPI:1144205519
Name:WHITWORTH, PAT W JR (MD)
Entity type:Individual
Prefix:DR
First Name:PAT
Middle Name:W
Last Name:WHITWORTH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST STE 310
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2004 HAYES ST STE 310
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2653
Practice Address - Country:US
Practice Address - Phone:615-620-5535
Practice Address - Fax:615-320-4303
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN207SG0201X174400000X
TN0213502086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3162056OtherBLUE CROSS BLUE SHIELD
4207493OtherAETNA
TNC71197OtherHEALTHSPRING
TN6026312OtherBCBS
TN3061644Medicaid
2615200OtherCIGNA
TN3061640Medicaid
TNC71197Medicare UPIN
2615200OtherCIGNA