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Individual

MARK TIMOTHY WEEKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1559 SPARTA ST, MC MINNVILLE, TN 37110-1316
(931) 815-4000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0000019028
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3036728
TN
01
4121001
BLUE CROSS
TN
01
P00296483
MEDICARE RAILROAD
TN
Enumeration date
06/06/2006
Last updated
11/07/2007
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