Provider Demographics
NPI:1184667537
Name:ALLISON, ANN C (OD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:C
Last Name:ALLISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:C
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:400 BUTLER CMNS
Mailing Address - Street 2:VISION CENTER 1885
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2496
Mailing Address - Country:US
Mailing Address - Phone:724-282-4054
Mailing Address - Fax:724-282-5645
Practice Address - Street 1:400 BUTLER CMNS
Practice Address - Street 2:VISION CENTER 1885
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2496
Practice Address - Country:US
Practice Address - Phone:724-282-4054
Practice Address - Fax:724-282-5645
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000698152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015066900001Medicaid
PA4696280001Medicare NSC
PA095943Medicare ID - Type Unspecified
PAU88331Medicare UPIN