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General NPI Number Information
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NPI Number | 1336950807
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE ALLIANCE
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1508 TOMBRAS AVE
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City | EAST RIDGE
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State | TN
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Zip | 37412-2720
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Country | US
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Telephone | 423-867-4969
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Fax | 423-805-4213
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Provider Business Mailing Address
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Address Line | 1508 TOMBRAS AVE
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City | EAST RIDGE
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State | TN
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Zip | 37412-2720
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Country | US
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Telephone | 423-867-4969
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Fax | 423-805-4213
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Authorized Official
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Title or Position | CREDENTIALING/BILLING MANAGER
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Name | TAMMY H SCOTT
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Credential |
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Telephone | 423-867-4969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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