Provider Demographics
NPI:1538122148
Name:JACOKES, ALLISON LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEWIS
Last Name:JACOKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ALLISON
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4020 WAKE FOREST ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-876-9797
Mailing Address - Fax:919-790-1254
Practice Address - Street 1:4020 WAKE FOREST ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-876-9797
Practice Address - Fax:919-790-1254
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35380207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC45677OtherBCBS
NC001960459004OtherUNITED HEALTHCARE
NC3904931OtherCIGNA
NC8945677Medicaid
NC001960459004OtherUNITED HEALTHCARE
NC45677OtherBCBS