Provider Demographics
NPI:1548245145
Name:CORNELL, ALLYSON N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:N
Last Name:CORNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1301 RIVERFRONT PKWY STE 209
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-3312
Mailing Address - Country:US
Mailing Address - Phone:423-634-5808
Mailing Address - Fax:423-634-3139
Practice Address - Street 1:1301 RIVERFRONT PKWY STE 209
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-3312
Practice Address - Country:US
Practice Address - Phone:423-634-5808
Practice Address - Fax:423-634-3139
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN38035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI23537Medicare UPIN