Provider Demographics
NPI:1275949711
Name:GLASER, ALESSANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:GLASER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MALLORY LN STE 130-539
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8209
Mailing Address - Country:US
Mailing Address - Phone:901-830-3971
Mailing Address - Fax:
Practice Address - Street 1:810 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774
Practice Address - Country:US
Practice Address - Phone:865-657-9303
Practice Address - Fax:865-657-9404
Is Sole Proprietor?:No
Enumeration Date:2014-07-04
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59392207Q00000X
TN55710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ027687Medicaid