Provider Demographics
NPI:1578661518
Name:OCULAM, ALEONA A (MD)
Entity Type:Individual
Prefix:
First Name:ALEONA
Middle Name:A
Last Name:OCULAM
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:PO BOX 440545
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0545
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:109 INDEPENDENCE LN
Practice Address - Street 2:SUITE 200
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3033
Practice Address - Country:US
Practice Address - Phone:423-562-4968
Practice Address - Fax:423-562-5603
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000034558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3864657Medicaid
H26462Medicare UPIN
TN3864657Medicare PIN