Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Izzuddin Ali Mansur, MD

Individual provider Urology Physician · NPI 1508828344

Dr. Izzuddin Ali Mansur, MD is an Urology in Crossville, Tennessee. Qualified in 1979, 47 years ago. Practices with Covenant Medical Group Inc, a 356-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
47
Licensed in
TN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

49 Cleveland St Ste 220
Crossville, TN 38555-2855
Phone: (931) 707-8050
Fax: (931) 707-8048
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence MD30604 (TN)

Record details

NPI number1508828344
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 5, 2006
Last updated in NPPESJune 14, 2021
Certification dateJune 14, 2021
Mailing address49 Cleveland St, Suite 220, Crossville, TN 38555-2855

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Covenant Medical Group Inc — 356 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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