Provider Demographics
NPI:1275948069
Name:STICKLES, ALLISON MICHELE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MICHELE
Last Name:STICKLES
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:234 GOODMAN ST
Mailing Address - Street 2:ML 665X
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2364
Mailing Address - Country:US
Mailing Address - Phone:513-584-7425
Mailing Address - Fax:513-584-7681
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:ML 665X
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-7425
Practice Address - Fax:513-584-7681
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.139379208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program