Head, Mark Edward
Head, Mark Edward is an individual health care provider with primary practice located at 301 Gordon Gutmann Blvd Ste 101 , Jeffersonville IN 47130-3765. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Head, Mark Edward can be contacted via phone (812) 282-4844.Contact Information
Primary practice address
301 Gordon Gutmann Blvd Ste 101
Jeffersonville IN 47130-3765
Phone: (812) 282-4844
Fax: (812) 282-6248
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01052682A | Indiana |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | 01052682A | Indiana |
Profile Details
| NPI number | 1639172570 |
|---|---|
| LBN Legal business name | Head, Mark Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Feb 23rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639172570 | NPPES |
| Kentucky | MEDICAID | 64026982 | |
| Kentucky | MEDICAID | 200262820 | |
| Kentucky | Other | 34228 | |
| Kentucky | Other | 01052682A |
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