Healthcare Provider Details

I. General information

NPI: 1770926859
Provider Name (Legal Business Name): ALLCARE MEDICAL TROY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 E HARPER ST
TROY TN
38260-5951
US

IV. Provider business mailing address

316 E HARPER ST
TROY TN
38260-5951
US

V. Phone/Fax

Practice location:
  • Phone: 731-536-4624
  • Fax: 731-536-4905
Mailing address:
  • Phone: 731-536-4624
  • Fax: 731-536-4905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARK A. JONES
Title or Position: OWNER
Credential: M.D.
Phone: 731-536-4624