Provider Demographics
NPI:1518321025
Name:DYE, ALYSSA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MICHELLE
Last Name:DYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N DUNLAP ST # 20
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2800
Mailing Address - Country:US
Mailing Address - Phone:901-287-6756
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF TENNESSEE
Practice Address - Street 2:920 MADISON AVENUE SUITE 447
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-287-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN57886207P00000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program