Provider Demographics
NPI:1154403962
Name:KUMAR, ALOK (MD)
Entity type:Individual
Prefix:DR
First Name:ALOK
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 N BROTHER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2760
Mailing Address - Country:US
Mailing Address - Phone:901-255-5221
Mailing Address - Fax:901-373-4511
Practice Address - Street 1:7900 AIRWAYS BLVD
Practice Address - Street 2:BLDG C SUITE 2
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4114
Practice Address - Country:US
Practice Address - Phone:662-349-5554
Practice Address - Fax:662-349-5570
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41595207V00000X
MD64864207V00000X
MS20526207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP0082773OtherMEDICARE RAILROAD
TN1512020Medicaid
TN4213445OtherBCBS
MS01585512Medicaid
TN1512020Medicaid
MS01585512Medicaid