Provider Demographics
NPI:1508809476
Name:ALLISON, JAMES P (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:ALLISON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-4430
Mailing Address - Country:US
Mailing Address - Phone:724-543-2976
Mailing Address - Fax:
Practice Address - Street 1:1 HILLTOP PLZ
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-8905
Practice Address - Country:US
Practice Address - Phone:724-919-5027
Practice Address - Fax:724-543-1341
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015115910001Medicaid
PAU91115Medicare UPIN
PA095945Medicare ID - Type Unspecified