Provider Demographics
NPI:1922037258
Name:ALBERTA, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:ALBERTA
Suffix:
Gender:M
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 339
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-0339
Mailing Address - Country:US
Mailing Address - Phone:423-401-6355
Mailing Address - Fax:423-886-1865
Practice Address - Street 1:MEDICAL TOWERS BUILDING, 1000 EAST THIRD STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-0000
Practice Address - Country:US
Practice Address - Phone:215-785-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07800000207R00000X
TN44927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102295517 0001-BUCKSMedicaid
NJ0059668Medicaid
PA102295517 0001-LOWERMedicaid
PA102295517 0001-LOWERMedicaid
NJI24171Medicare UPIN
PA151260ZDKTMedicare PIN
PA102295517 0001-BUCKSMedicaid