Basic Information
Provider Information
NPI: 1659379543
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVEY
FirstName: TERENCE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: D.P.M.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 CROSSLAKE DR
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477158198
CountryCode: US
TelephoneNumber: 8124771558
FaxNumber:  
Practice Location
Address1: 225 CROSSLAKE DR
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477158198
CountryCode: US
TelephoneNumber: 8124771558
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/13/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XX0004X07000612AINY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery

ID Information
IDTypeStateIssuerDescription
17962201 HEALTHLINKOTHER
00000027863901 ANTHEMOTHER


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