Provider Demographics
NPI:1730476839
Name:DAIGLE, ALISON CLAIRE (DO)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CLAIRE
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LBX 7650
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 CAMPUS AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6045
Practice Address - Country:US
Practice Address - Phone:207-777-4455
Practice Address - Fax:207-777-4458
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO26052084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEDO2605OtherMEDICAL LICENSE
RIDO00806OtherMEDICAL LICENSE