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General NPI Number Information
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NPI Number | 1831175603
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Entity Type | Organization
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Legal Business Name | ALPHA MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 209 COLLEGE ST
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City | LAFAYETTE
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State | TN
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Zip | 37083-1701
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Country | US
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Telephone | 615-666-2056
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Fax | 615-666-3022
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Provider Business Mailing Address
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Address Line | 209 COLLEGE ST
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City | LAFAYETTE
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State | TN
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Zip | 37083-1701
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Country | US
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Telephone | 615-666-2056
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Fax | 615-666-3022
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Authorized Official
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Title or Position | PROVIDER
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Name | OLUFEMI O ODUNUSI
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Credential | MD
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Telephone | 615-666-2056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | MD024943
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License Number State | TN
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Taxonomy #2
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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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