Basic Information
Provider Information
NPI: 1366492530
EntityType: 2
ReplacementNPI:  
OrganizationName: DAWN S. ALLISON, MD, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1208 BEALL LN
Address2:  
City: CENTRAL POINT
State: OR
PostalCode: 975021573
CountryCode: US
TelephoneNumber: 5416645151
FaxNumber: 5416645155
Practice Location
Address1: 1510 NANCY WAY
Address2:  
City: BEND
State: OR
PostalCode: 977023215
CountryCode: US
TelephoneNumber: 5413229000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/11/2006
LastUpdateDate: 11/26/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALLISON
AuthorizedOfficialFirstName: DAWN
AuthorizedOfficialMiddleName: S.
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5413229000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansDermatology 

No ID Information.


Home