Provider Demographics
NPI:1649587114
Name:ATKINSON, ALISON FAE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:FAE
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:FAE
Other - Last Name:SCHINDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:330 E 8TH ST STE 151
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3383
Practice Address - Country:US
Practice Address - Phone:740-374-4945
Practice Address - Fax:740-374-4943
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50003686363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0108203Medicaid
OH0108203Medicaid
OHH363320Medicare PIN
OHH363321Medicare PIN