Provider Demographics
NPI:1013904895
Name:STILES, ALLISON M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:STILES
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 1:1325 EASTMORELAND AVE
Mailing Address - Street 2:#585
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3519
Mailing Address - Country:US
Mailing Address - Phone:901-276-0249
Mailing Address - Fax:901-276-0996
Practice Address - Street 1:1325 EASTMORELAND AVE STE 585
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7506
Practice Address - Country:US
Practice Address - Phone:901-276-0249
Practice Address - Fax:901-276-0996
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37741207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04733009Medicaid
TN8550170OtherCIGNA
TN000000171094OtherUNISON/BETTER HEALTH PLAN
LA1524964Medicaid
TN41460OtherTLC
TN3888054Medicaid
TN4100815OtherBCBST
TNP00261567OtherRR MEDICARE
TN7404504OtherAETNA HMO
TN3888054Medicaid
LA1524964Medicaid