Basic Information
| Provider Information | |||||||||
| NPI: | 1679506356 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALISON A CLAREY DO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635913 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374394145 | ||||||||
| FaxNumber: | 9374394371 | ||||||||
| Practice Location | |||||||||
| Address1: | 2717 MIAMISBURG CENTERVILLE RD | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | CENTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374394145 | ||||||||
| FaxNumber: | 9374394371 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | CLAREY | ||||||||
| AuthorizedOfficialFirstName: | ALISON | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9374394145 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2511268 | 05 | OH | MEDICAID |