Provider Demographics
NPI:1700853827
Name:SCARBOROUGH, ALLISON L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:L
Last Name:SCARBOROUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3619
Mailing Address - Country:US
Mailing Address - Phone:541-687-6508
Mailing Address - Fax:
Practice Address - Street 1:1180 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3619
Practice Address - Country:US
Practice Address - Phone:541-687-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22521207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR288463Medicaid
ORRR PTAN 110206459Medicare PIN
ORR106878Medicare PIN
OR288463Medicaid