Provider Demographics
NPI:1508062092
Name:ALLERY & ASTHMA ASSOCIATES
Entity Type:Organization
Organization Name:ALLERY & ASTHMA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:937-431-0721
Mailing Address - Street 1:2359 LAKEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3695
Mailing Address - Country:US
Mailing Address - Phone:937-431-0721
Mailing Address - Fax:937-431-5419
Practice Address - Street 1:30 WEST MCCREIGHT AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1842
Practice Address - Country:US
Practice Address - Phone:937-323-3585
Practice Address - Fax:937-431-5419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2493387Medicaid
OH2493387Medicaid