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Individual
BENNIE W WHITEHEAD
Active
Individual
BENNIE W WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
018427
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000361799
ANTHEM BCBS OF KY
KY
01
—
3058965
BCBS OF TENNESSEE
TN
05
—
3065071
—
TN
01
—
P00255557
RAILROAD MEDICARE
TN
Enumeration date
07/05/2006
Last updated
11/19/2007
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