Provider Demographics
NPI:1982650727
Name:ALLSOP, BRUCE NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:NEAL
Last Name:ALLSOP
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Gender:M
Credentials:MD
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Mailing Address - Street 1:280 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3398
Mailing Address - Country:US
Mailing Address - Phone:865-539-0270
Mailing Address - Fax:865-560-9209
Practice Address - Street 1:220 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3398
Practice Address - Country:US
Practice Address - Phone:865-539-0270
Practice Address - Fax:865-560-9209
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-01-17
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Provider Licenses
StateLicense IDTaxonomies
TN20818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3053371Medicaid
TN3053371Medicaid
TNC71931Medicare UPIN