Provider Demographics
NPI:1770926859
Name:ALLCARE MEDICAL TROY, PLLC
Entity type:Organization
Organization Name:ALLCARE MEDICAL TROY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-536-4624
Mailing Address - Street 1:316 E HARPER ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:TN
Mailing Address - Zip Code:38260-5951
Mailing Address - Country:US
Mailing Address - Phone:731-536-4624
Mailing Address - Fax:731-536-4905
Practice Address - Street 1:316 E HARPER ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:TN
Practice Address - Zip Code:38260-5951
Practice Address - Country:US
Practice Address - Phone:731-536-4624
Practice Address - Fax:731-536-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty