Provider Demographics
NPI:1326255746
Name:SMITH, ALISON JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7618
Mailing Address - Country:US
Mailing Address - Phone:515-491-1365
Mailing Address - Fax:
Practice Address - Street 1:404 JEFFERSON ST
Practice Address - Street 2:MEDICAL IMAGING DEPARTMENT
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1257
Practice Address - Country:US
Practice Address - Phone:641-628-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010160832085R0202X
IA39932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology