Provider Demographics
NPI:1710096938
Name:ALISON, HAROLD WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:WAYNE
Last Name:ALISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 MEADOWVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660
Mailing Address - Country:US
Mailing Address - Phone:423-230-5000
Mailing Address - Fax:423-230-5097
Practice Address - Street 1:2428 KNOB CREEK ROAD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-282-5054
Practice Address - Fax:423-230-5097
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD06301174400000X
VA0101225600174400000X, 207RI0011X, 207RC0000X
TN6301207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA320314OtherANTHEM
TNTN0101OtherJDH
NC89014ATMedicaid
TN4017255OtherBCBS
VA005865581Medicaid
TN3373123Medicaid
NC890547EMedicaid
VAC08273Medicare ID - Type UnspecifiedGROUP#
TN3373123Medicare ID - Type UnspecifiedGROUP#
TN3373123Medicaid
TN4017255OtherBCBS
TNTN0101OtherJDH
TN103I069102Medicare PIN