Provider Demographics
NPI:1588616098
Name:HELLMANN, MARK B (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:HELLMANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1855 TANNER WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8331
Mailing Address - Country:US
Mailing Address - Phone:865-882-4944
Mailing Address - Fax:865-285-9684
Practice Address - Street 1:1855 TANNER WAY STE 130
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8331
Practice Address - Country:US
Practice Address - Phone:865-882-4944
Practice Address - Fax:865-285-9684
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM608213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ045081Medicaid
TNP00363617OtherRAILROAD MEDICARE
TN4127674OtherBCBS TN
TN5730900001Medicare NSC
TN3353920Medicare PIN
TNP00363617OtherRAILROAD MEDICARE