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NPI Code Detail

MEDICARE: MR. MATTHEW JOSEPH ALLMAN PA

MEDICARE: MR. MATTHEW JOSEPH ALLMAN PA
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
1363AM0700XMedical Physician AssistantPA1140TN

General Provider Information

NPI Number : 1659378040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW JOSEPH ALLMAN PA
Provider Business Mailing Address
First Line : PO BOX 1000 DEPT 0194
Second Line :
City : MEMPHIS
State : TN
Zip : 38148-0194
Country : US
Telephone Number : 901-821-0338
Fax Number : 901-821-0384
Provider Business Practice Location Address
First Line : 4100 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-2502
Country : US
Telephone Number : 901-213-5460
Fax Number : 901-213-5463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/05/2013

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