Individual
MR. CAMERON WAYNE HEADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
457 VISTA DR, SPARTA, TN 38583-1360
(931) 738-3383
(931) 738-8911
Mailing address
457 VISTA DR, SPARTA, TN 38583-1360
(931) 738-3383
(931) 738-8911
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1441
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3665152
—
TN
Enumeration date
02/27/2007
Last updated
11/23/2009
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