Provider Demographics
NPI:1649413212
Name:DELGADO, ALISON JANINE (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JANINE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:JANINE
Other - Last Name:BEDINGFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:750 ROUND VALLEY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-7548
Mailing Address - Country:US
Mailing Address - Phone:435-655-0926
Mailing Address - Fax:435-649-3748
Practice Address - Street 1:750 ROUND VALLEY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7548
Practice Address - Country:US
Practice Address - Phone:435-655-0926
Practice Address - Fax:435-649-3748
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098684208000000X
UT8527031.1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics