Provider Demographics
NPI:1528590866
Name:ESPINOSA, ALLINA CONCEPCION (DO)
Entity Type:Individual
Prefix:
First Name:ALLINA CONCEPCION
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 DAWSON COMMONS CIR STE 320
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6268
Mailing Address - Country:US
Mailing Address - Phone:706-216-2771
Mailing Address - Fax:706-216-2944
Practice Address - Street 1:300 DAWSON COMMONS CIR STE 320
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6268
Practice Address - Country:US
Practice Address - Phone:706-216-2771
Practice Address - Fax:706-216-2944
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97075208000000X
TNDO0000004009208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPENDINGMedicaid
GA003292937AMedicaid