Provider Demographics
NPI:1700094059
Name:ALGEA, WILLIAM LEROY III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LEROY
Last Name:ALGEA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1561 CUBA MILLINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-5105
Mailing Address - Country:US
Mailing Address - Phone:901-876-6369
Mailing Address - Fax:901-876-6369
Practice Address - Street 1:4771 EASLEY ST
Practice Address - Street 2:MILLINGTON MEDICAL CLINIC
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1931
Practice Address - Country:US
Practice Address - Phone:901-873-2653
Practice Address - Fax:901-873-0388
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD009358208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice