Provider Demographics
NPI:1497748487
Name:ALLISON, LYNN E (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:E
Last Name:ALLISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BUSINESS PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7451
Mailing Address - Country:US
Mailing Address - Phone:417-239-0125
Mailing Address - Fax:417-239-0127
Practice Address - Street 1:110 BUSINESS PARK DR STE A
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7451
Practice Address - Country:US
Practice Address - Phone:417-239-0125
Practice Address - Fax:417-239-0127
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000154987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507300903Medicaid
17026OtherCOX HEALTH
252725OtherHEALTHLINK
MO167661OtherBLUE CROSS BLUE SHIELD
MO205948904Medicaid