Provider Demographics
NPI:1811167802
Name:IRFAN ALI, MD, PLLC
Entity type:Organization
Organization Name:IRFAN ALI, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-753-7700
Mailing Address - Street 1:1384 CORDOVA COVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2219
Mailing Address - Country:US
Mailing Address - Phone:901-753-7700
Mailing Address - Fax:901-753-7038
Practice Address - Street 1:1384 CORDOVA COVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2219
Practice Address - Country:US
Practice Address - Phone:901-753-7700
Practice Address - Fax:901-753-7038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
TN0321932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3852339Medicare UPIN
TN38523382Medicare UPIN