Provider Demographics
NPI:1467621524
Name:ALLISON, SEAN C (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:C
Last Name:ALLISON
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 1:6190 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6969
Mailing Address - Country:US
Mailing Address - Phone:850-476-9236
Mailing Address - Fax:850-476-9818
Practice Address - Street 1:6190 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6969
Practice Address - Country:US
Practice Address - Phone:850-476-9236
Practice Address - Fax:850-476-9818
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD28098207W00000X, 207WX0107X
FLME132342207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51153620OtherBLUE CROSS BLUE SHIELD
AL166153Medicaid
AL166153Medicaid
LA2138421Medicaid