Basic Information
| Provider Information | |||||||||
| NPI: | 1285633925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUNSFORD | ||||||||
| FirstName: | ALESHIA | ||||||||
| MiddleName: | LYNN-ANN | ||||||||
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| Credential: | MD, FAAP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2018 W CLINCH AVE | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235876842 | ||||||||
| FaxNumber: | 4235876842 | ||||||||
| Practice Location | |||||||||
| Address1: | 2018 W CLINCH AVE | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655418105 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2005 | ||||||||
| LastUpdateDate: | 04/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD33808 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics | 207P00000X | MD0000033808 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3854831 | 05 | TN | MEDICAID |