Individual
MOHAMMAD A ALSOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 HIGHWAY 70 E STE 102, DICKSON, TN 37055-2080
(615) 375-1531
(615) 375-1526
Mailing address
127 CRESTVIEW PARK DR STE 209, DICKSON, TN 37055-2856
(615) 446-5121
(615) 446-1359
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
38437
TN
207RP1001X
Pulmonary Disease Physician
Primary
38437
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I295563
MEDICARE
TN
05
—
1516719
—
TN
05
—
3894698
—
TN
01
—
4138005
BLUE CROSS BLUE SHIELD TN
TN
01
—
6060612
BCBS
TN
01
—
P00359629
RAILROAD MEDICARE PIN
—
Enumeration date
09/12/2005
Last updated
04/16/2025
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