Individual
DR. MARK EDWARD HEAD
Active
Individual
DR. MARK EDWARD HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01052682A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
01052682A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01052682A
STATE LICENSE
IN
05
—
200262820
—
IN
01
—
34228
STATE LICENSE
KY
05
—
64026982
—
KY
Enumeration date
05/24/2005
Last updated
07/14/2026
Update your record
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