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Individual

MRS. IANTHA LUCILLE ALLTON

Active
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Individual

MRS. IANTHA LUCILLE ALLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
41015
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1509268
MEDICAID - TN
TN
05
1509268
TN
05
3338876
TN
05
3338877
TN
01
4133805
BCBS
TN
01
4133808
BCBS
TN
01
4200560
BCBS TN
TN
01
4291492
BCBS - MTI
TN
05
7100039390
KY
Enumeration date
06/03/2006
Last updated
06/17/2025
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