Provider Demographics
NPI:1376500876
Name:ALLISON, DONALD W (PA)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:W
Last Name:ALLISON
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:4920 SO. 30TH STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1656
Mailing Address - Country:US
Mailing Address - Phone:402-734-4110
Mailing Address - Fax:402-734-3990
Practice Address - Street 1:4920 SO. 30TH STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1656
Practice Address - Country:US
Practice Address - Phone:402-734-4110
Practice Address - Fax:402-734-3990
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-06-07
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Provider Licenses
StateLicense IDTaxonomies
NE769363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE769OtherNE LICENSE