Healthcare Provider Details

I. General information

NPI: 1487340741
Provider Name (Legal Business Name): JOSEPH RILEY ALEF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 S GREEN ST
TUPELO MS
38804-6556
US

IV. Provider business mailing address

504 VALLEYVIEW DR
NEW ALBANY MS
38652-4709
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-2189
  • Fax:
Mailing address:
  • Phone: 662-266-0451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: