Individual
DR. JOSHUA DREW WHITLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1135 BROADWAY ST, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Mailing address
1135 BROADWAY ST, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02720
TN
207Q00000X
Family Medicine Physician
02888
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I089052
MEDICARE B-TN
TN
05
—
4047266
—
TN
05
—
64111669
—
KY
Enumeration date
05/24/2005
Last updated
09/06/2016
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