| David Alfredson Md Pc | |
|
529 W Commerce St Lewisburg TN 37091-3219 | |
| (931) 276-2234 | |
| (931) 276-2233 |
| Full Name | David Alfredson Md Pc |
|---|---|
| Speciality | Radiology |
| Location | 529 W Commerce St, Lewisburg, Tennessee |
| Authorized Official Name and Position | David Alfredson (PRESIDENT) |
| Authorized Official Contact | 9312762234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Alfredson Md Pc Po Box 2361 Lewisburg TN 37091-1361 Ph: (931) 276-2234 | David Alfredson Md Pc 529 W Commerce St Lewisburg TN 37091-3219 Ph: (931) 276-2234 |
| NPI Number | 1487771200 |
|---|---|
| Provider Enumeration Date | 03/25/2007 |
| Last Update Date | 10/28/2024 |
| Medicare PECOS PAC ID | 0446423438 |
|---|---|
| Medicare Enrollment ID | O20111108000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487771200 | NPI | - | NPPES |
| 149997 | Other | TN | BLUE CROSS BLUE SHIELD TN |
| 3383775 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | MD 13280 (Tennessee) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD 13280 (Tennessee) | Primary |
| Provider Name | David Alfredson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720105547 PECOS PAC ID: 7214975440 Enrollment ID: I20050419000966 |
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