Provider Demographics
NPI:1124222963
Name:EATON, ALLISON M (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:EATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-546-1642
Mailing Address - Fax:865-305-6195
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-546-1642
Practice Address - Fax:865-305-6195
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42432207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000367Medicaid
TN3000367Medicaid