Provider Demographics
NPI:1033548151
Name:ALLMAN, ALICIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TOWER RD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-9411
Mailing Address - Country:US
Mailing Address - Phone:770-514-7550
Mailing Address - Fax:770-514-1390
Practice Address - Street 1:400 TOWER RD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9411
Practice Address - Country:US
Practice Address - Phone:770-514-7550
Practice Address - Fax:770-514-1390
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant