Healthcare Provider Details

I. General information

NPI: 1811638273
Provider Name (Legal Business Name): ALLEE CHASLYN MAXWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 OAK RIDGE TPKE
OAK RIDGE TN
37830-6976
US

IV. Provider business mailing address

1125 N CHURCH ST
GREENSBORO NC
27401-1007
US

V. Phone/Fax

Practice location:
  • Phone: 865-835-1000
  • Fax:
Mailing address:
  • Phone: 336-832-8035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number72601
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number72601
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: