Provider Demographics
NPI:1598858052
Name:MCPHEARSON, ALLYSON JEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:JEAN
Last Name:MCPHEARSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:ALLYSON
Other - Middle Name:JEAN
Other - Last Name:LITHERLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1415 NORTH 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036
Mailing Address - Country:US
Mailing Address - Phone:765-552-7585
Mailing Address - Fax:
Practice Address - Street 1:3240 SOUTH WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952
Practice Address - Country:US
Practice Address - Phone:765-662-3936
Practice Address - Fax:765-662-3978
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ18002574B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist