Healthcare Provider Details

I. General information

NPI: 1902267487
Provider Name (Legal Business Name): JOHN C WESTERKAMM MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 DUNBAR CAVE RD STE 102
CLARKSVILLE TN
37043-6572
US

IV. Provider business mailing address

451 NORTHCREST DR
SPRINGFIELD TN
37172-3973
US

V. Phone/Fax

Practice location:
  • Phone: 931-266-0808
  • Fax: 615-433-7303
Mailing address:
  • Phone: 615-433-7302
  • Fax: 615-433-7303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number44369
License Number StateTN

VIII. Authorized Official

Name: DR. JOHN COLEMAN WESTERKAMM
Title or Position: OWNER
Credential: M.D.
Phone: 615-433-7302