Individual provider · NPI-1

Thomas T Alleva, PA-C

Physician Assistant, Medical · Jackson, TN

NPI number1699122879
StatusActive
Last updated in NPPESJun 10, 2024

Details

NPI
1699122879
Entity type
Individual (NPI-1)
Name
Thomas T Alleva
Credential
PA-C
Sex
Male
Sole proprietor
Yes
Enumeration date
May 18, 2016
Certification date
Jun 10, 2024
Last updated
Jun 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, Medical3030TNYes
207P00000X Emergency Medicine3030TN
207Q00000X Family Medicine3030TN
208600000X Surgery3030TN
207R00000X Internal Medicine3030TN
208000000X Pediatrics3030TN
208100000X Physical Medicine & Rehabilitation3030TN
2085R0202X Radiology, Diagnostic Radiology3030TN

Practice location

620 Skyline Dr
Jackson, TN 38301-3923

Phone 731-541-5000

Mailing address

620 Skyline Dr
Jackson, TN 38301-3923

Phone 731-541-5000

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