Provider Demographics
NPI:1366443202
Name:ALLING, R. DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:DOUGLAS
Last Name:ALLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1728
Mailing Address - Country:US
Mailing Address - Phone:585-393-2811
Mailing Address - Fax:
Practice Address - Street 1:335 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1728
Practice Address - Country:US
Practice Address - Phone:585-393-2888
Practice Address - Fax:585-396-9275
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213797208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010213797OtherBLUE CHOICE
NY01951266Medicaid
NYMDE392OtherPREFERRED CARE - IM
NYMDE393OtherPREFERRED CARE - PEDS
NY1407OtherBLUE SHIELD
NY1407OtherBLUE SHIELD