Provider Demographics
NPI:1639112154
Name:SMALLY, ALAN J (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:SMALLY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:65 KANE ST
Mailing Address - Street 2:UCONN HEALTH/PROVIDER ENROLLMENT
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:JOHN DEMPSEY HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-0001
Practice Address - Country:US
Practice Address - Phone:860-679-3486
Practice Address - Fax:860-679-3489
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT027847207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine