Provider Demographics
NPI:1497750756
Name:ALLISON, RON R (MD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:R
Last Name:ALLISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:801 W H SMITH BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3764
Practice Address - Country:US
Practice Address - Phone:252-329-0025
Practice Address - Fax:252-329-0325
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0000007522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8927518OtherCIGNA
NC920005999OtherRAILROAD MEDICARE
NC127YYOtherBCBS NC
NC89127YYMedicaid
NCP00807985OtherRAILROAD MEDICARE 12 17 09
NC89127YYMedicaid
NCP00807985OtherRAILROAD MEDICARE 12 17 09
NC2282620Medicare PIN