Provider Demographics
NPI:1750335980
Name:ALLEGRY & ENT ASSOCIATES OF MIDDLE TENNESSEE, P.C.
Entity type:Organization
Organization Name:ALLEGRY & ENT ASSOCIATES OF MIDDLE TENNESSEE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-889-8802
Mailing Address - Street 1:3901 CENTRAL PIKE
Mailing Address - Street 2:SUITE 351
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3419
Mailing Address - Country:US
Mailing Address - Phone:615-889-8802
Mailing Address - Fax:615-889-0583
Practice Address - Street 1:3901 CENTRAL PIKE
Practice Address - Street 2:SUITE 351
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3419
Practice Address - Country:US
Practice Address - Phone:615-889-8802
Practice Address - Fax:615-889-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3715240Medicare PIN