Provider Demographics
NPI:1659378040
Name:ALLMAN, MATTHEW JOSEPH (PA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:ALLMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1000 DEPT 0194
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0194
Mailing Address - Country:US
Mailing Address - Phone:901-821-0338
Mailing Address - Fax:901-821-0384
Practice Address - Street 1:4100 AUSTIN PEAY HWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2502
Practice Address - Country:US
Practice Address - Phone:901-213-5460
Practice Address - Fax:901-213-5463
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2013-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNPA1140363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ28261Medicare UPIN
TN3662872Medicare ID - Type Unspecified