Provider Demographics
NPI:1669450045
Name:THOMAS, ALLISON R (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX L3129
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:45260
Mailing Address - Country:US
Mailing Address - Phone:937-232-2362
Mailing Address - Fax:937-534-0166
Practice Address - Street 1:3924 MOUNTVIEW RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-4806
Practice Address - Country:US
Practice Address - Phone:614-338-9158
Practice Address - Fax:614-459-8630
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08414363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTHNP19725Medicare PIN
OHQ57619Medicare UPIN
OHNP19726 (PTAN)Medicare PIN