Alley, Mark W

Alley, Mark W is an individual health care provider with primary practice located at 135 W Ravine Rd Suite 5-B, Kingsport TN 37660-3847. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Alley, Mark W can be contacted via phone (423) 224-3460.

Contact Information

Primary practice address
135 W Ravine Rd Suite 5-B Kingsport TN 37660-3847
Phone: (423) 224-3460
Fax: (423) 224-3465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 20227 Tennessee

Profile Details

NPI number 1013916295
LBN Legal business name Alley, Mark W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Apr 7th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013916295 NPPES
Tennessee MEDICAID 3061778
Tennessee Other 3037574
Tennessee Other 00013859
Tennessee MEDICAID 100011088
Tennessee MEDICAID 5900346
Tennessee Other TN0100
Tennessee Other 064423
Tennessee MEDICAID 005749221

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