MEDICARE: DR. ALISHA JEFFERSON M.D.

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	208600000X	Surgery Physician	59128	TN

General Provider Information

NPI Number	:	1366860819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALISHA JEFFERSON M.D.

Provider Business Mailing Address
First Line	:	739 PRESIDENT PL STE 120
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-6845
Country	:	US
Telephone Number	:	615-768-5003
Fax Number	:

Provider Business Practice Location Address
First Line	:	739 PRESIDENT PL STE 120
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-6845
Country	:	US
Telephone Number	:	615-768-5003
Fax Number	:

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

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	08/26/2025

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