MEDICARE: DR. JOHN DALE ALDEN III PH.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	103G00000X	Clinical Neuropsychologist	P1725	TN
2	103TC0700X	Clinical Psychologist	P1725	TN

General Provider Information

NPI Number	:	1992772206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DALE ALDEN III PH.D.

Provider Business Mailing Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	10
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	615-351-3987
Fax Number	:	931-380-0058

Provider Business Practice Location Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	10
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	615-351-3987
Fax Number	:	931-380-0058

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

Provider Enumeration Date	:	03/06/2006
Last Update Date	:	09/11/2025

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