Provider Demographics
NPI:1558461970
Name:WHEATLEY, ROBERT M (MD FACC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:WHEATLEY
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1562
Mailing Address - Country:US
Mailing Address - Phone:615-515-1900
Mailing Address - Fax:615-292-4633
Practice Address - Street 1:2400 PATTERSON ST
Practice Address - Street 2:SUITE 502
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1562
Practice Address - Country:US
Practice Address - Phone:615-515-1900
Practice Address - Fax:615-292-4633
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29441207RI0011X
TNMD024506207RI0011X
TN24506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64916257Medicaid
TN3854977Medicaid
TN3854977Medicare PIN
TNP00379437Medicare PIN