MEDICARE: DR. PHEBE LORE ALLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	73723	MN
2	207Q00000X	Family Medicine Physician	M-16235	ID

General Provider Information

NPI Number	:	1295355279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHEBE LORE ALLEY MD

Provider Business Mailing Address
First Line	:	400 E 3RD ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55805-1951
Country	:	US
Telephone Number	:	218-786-8364
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 E 1ST ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55805-1901
Country	:	US
Telephone Number	:	218-786-8364
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	03/16/2026

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