Provider Demographics
NPI:1164562542
Name:FORSYTHE, ALISON PAIGE (RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:PAIGE
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:PAIGE
Other - Last Name:ARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD,LD
Mailing Address - Street 1:550 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-3820
Mailing Address - Country:US
Mailing Address - Phone:918-588-1900
Mailing Address - Fax:918-582-6405
Practice Address - Street 1:550 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-3820
Practice Address - Country:US
Practice Address - Phone:918-588-1900
Practice Address - Fax:918-582-6405
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100732910-AOtherGROUP MEDICAID/SOONERCARE
OK73-1042545OtherGROUP MEDICARE
OK731042545001OtherGROUP TRICARE
OK100732910-GOtherGROUP MEDICAID/SOONERCARE
OK73-1042545OtherGROUP BCBS
OK200556340 AMedicaid
OK73-1042545OtherGROUP COMMUNITY CARE OF OKLAHOMA