Healthcare Provider Details

I. General information

NPI: 1538021852
Provider Name (Legal Business Name): ALEXANDER THOMAS AVERNA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 NOBLE ST
SMITHFIELD NC
27577-9300
US

IV. Provider business mailing address

97 MYSTERY HILL CT
CLAYTON NC
27520-3056
US

V. Phone/Fax

Practice location:
  • Phone: 919-989-9559
  • Fax:
Mailing address:
  • Phone: 919-989-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5973
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: