Healthcare Provider Details

I. General information

NPI: 1548227416
Provider Name (Legal Business Name): JOHN B. WHEELOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N STE 600
NASHVILLE TN
37203-1534
US

IV. Provider business mailing address

330 23RD AVE N STE 600
NASHVILLE TN
37203-1534
US

V. Phone/Fax

Practice location:
  • Phone: 615-340-4640
  • Fax: 615-340-4642
Mailing address:
  • Phone: 615-340-4640
  • Fax: 615-340-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD21128
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number21128
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: