Healthcare Provider Details

I. General information

NPI: 1447368311
Provider Name (Legal Business Name): JIMMY ALELE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W HIGH ST SUITE 450
LIMA OH
45801-3990
US

IV. Provider business mailing address

PO BOX 636930
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5240
  • Fax: 419-996-5242
Mailing address:
  • Phone: 513-981-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number27122
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35-095774
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier271226
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: